V  '••       •  .\.:..\  \A,v\V\\\\\\,\ 


aaaaaaaaaaaaaa<aaaaaaaaaaoaaaaaaaaaaa<a 


Exchange  from 
C.  M.  E.  Loma  Linda 


COLLEGE  OF   OSTEOPATHIC   PHYSICIANS 
AND  SURGEONS   •  LOS  ANGELES,  CALIFORNIA 


In  the  above  diagram  the  position  of  the  stomach  will  be 
clearly  seen,  together  with  its  relation  to  other  internal  organs. 
I.  Stomach,  partially  covered  by  the  liver  and  lungs;  111.  Small 
intestines ;  IV.  Colon ;  V.  Lower  or  sigmoid  portion  of  the 
colon. 

PLATE  I.— INTERNAL  ORGANS. 


THE 


ITS  DISORDERS,  AND 


How  TO  CURE  THEM 


BY  J.  H.  KELLOGG,  M.  D., 


President  of  the  Medical  Missionary   College,    Chicago,  III.;  Member  of  the  Brit- 

ish   Gynecological   Society;    International   Periodical    Congress   of  Gynecology 

and    Obstetrics  ;  British    and  American  Associations  for  the  Advancement 

of  Science;    the  Socictt  d'  ffygiine  of  France  ;  Pan-American  Congress 

of  Religion   and  Education;    American   Society   of  Miaroscopisls  ; 

American.   Electro-Therapeutic  Association;  American  Climato- 

logical  Society  ;   American  Medical  Association  ;  Mississippi 

Valley  Medical  Association;  Tri-State  Medical  Society; 

Michigan  State  Medical  Society;  Superintendent 

of  the   Battle    Creek   (Mich.)   Sanitarium. 


ILLUSTRATED. 


MODERN  MEDICINE  PUB.  CO., 

BATTLE  CREEK,  MICH. 

CHICAGO:  NEW  YORK:  LONDON. 

1896. 


Entered  according  to  Act  of  Congress,  in  the  year  1896, 

BY  J.  H.  KELLOGG,  M.  D., 
In  the  office  of  the  Librarian  of  Congress,  at  Washington,  D.  C. 


ALL  RIGHTS  RESERVED. 


Entered  also  at  Stationers'  Hall,  London,  England. 


To 

MV 


This  Book 
Is 

Affectionately  Dedicated 


PREFACE. 


AN  eminent  comparative  anatomist  defines  an  animal  as  "a 
stomach  with  various  organs  appended," — a  definition  which 
presents  in  a  very  clear  light  the  relative  importance  of  the 
stomach  in  the  association  of  the  organs  and  structures  which 
constitute  the  human  as  well  as  the  animal  body.  The  stomach 
must  certainly  be  regarded  as  the  center  of  the  nutritive  proc- 
esses of  the  body,  and  any  derangement  of  its  functions  must 
therefore  result  in  disorder  of  the  entire  organism. 

The  close  relation  between  the  condition  of  the  stomach  and 
that  of  the  mind  has  been  observed  even  by  the  most  primitive 
nations,  and  has  led  some  of  them  to  regard  the  stomach  as  the 
veritable  seat  of  the  soul.  There  is  sound  truth  in  the  ancient 
German  adage.  "As  a  man  eateth,  so  is  he." 

It  may  truly  be  said  that  disorders  of  digestion  are  the  most 
prevalent  of  all  human  ills,  and  investigators  within  the  last 
twenty  years  have  been  making  more  and  more  clear  the  fact 
that  the  great  majority  of  diseases  are  primarily  due  to  derange- 
ment of  the  digestive  processes.  The  remarkable  researches  of 
Professor  Bouchard,  of  Paris,  and  others,  have  shown  that  such 
diseases  as  consumption,  typhoid  fever,  and  cholera,  as  well  as 
Bright's  disease  and  analogous  maladies,  are  indirectly,  if  not 
directly,  due  to  a  disordered  condition  of  the  stomach,  as  the 
result  of  which  the  defenses  of  the  body  are  broken  down,  and 
infection  rendered  possible. 

Notwithstanding  the  great  prevalence  of  stomach  disorders, 
and  the  large  amount  of  knowledge  and  experience  which  have 
been  accumulated  by  the  profession  in  regard  to  them  within 
the  last  few  years,  it  is  nevertheless  true  that  no  other  class  of 
curable  disorders  has  more  frequently  baffled  the  best  directed 
efforts  of  medical  practitioners.  This  is  doubtless  owing  to 
the  imperfect  knowledge  of  the  processes  of  digestion  and  of 
the  nature  of  the  disorders  to  which  the  digestive  organs  are 
subject  which  has  prevailed  from  the  earliest  times  to  within  a 
comparatively  brief  period.  Within  the  last  score  of  years, 


£7071 


4-  THE    STOMACH. 

however,  marvelous  progress  has  been  made  in  the  study  of  the 
stomach  and  its  work,  through  the  use  of  the  stomach-tube,  and 
by  the  aid  of  experimental  researches  undertaken  by  numerous 
European  and  a  few  American  investigators. 

As  the  result  of  these  inquiries,  a  great  many  most  interesting 
and  important  facts  have  been  discovered,  which  have  almost 
wholly  revolutionized  our  ideas  respecting  the  nature  of  di- 
gestive ailments  and  successful  methods  of  treatment. 

One  of  the  leading  purposes  of  this  book  is  to  call  attention 
to  these  newer  facts  in  relation  to  the  digestive  processes,  and 
especially  to  point  out  their  relation  to  the  prevention  and  suc- 
cessful treatment  of  dyspepsia  and  allied  ailments.  As  will  be 
seen  by  reference  to  the  table  of  contents,  the  work  embodies, 
first,  a  brief  sketch  of  the  processes  of  digestion  ;  then  a  consider- 
ation of  the  causes  of  indigestion,  and  their  bearing  upon  die- 
tetic and  other  habits,  to  which  is  added  a  description  of  the 
various  symptoms  present  in  functional  diseases  of  the  stomach, 
together  with  the  means  by  which  they  may  be  relieved,  fol- 
lowed by  a  consideration  of  each  of  the  several  classes  of  di- 
gestive disorders,  and  the  proper  dietetic  and  other  measures 
necessary  for  their  cure. 

In  the  study  of  the  practical  part  of  the  work,  it  will  be 
noticed  that  the  measures  of  treatment  recommended  are  of  a 
remarkably  simple  character.  This  may  lead  to  the  impression 
that  they  are  lacking  in  efficiency  ;  hence  it  may  be  proper  to 
say  in  their  defense,  that  many  years  of  experience  in  the  treat- 
ment of  a  large  number  of  patients  of  this  class,  in  connection 
with  the  Battle  Creek  (Mich.)  Sanitarium,  have  fully  established 
the  author  in  the  belief  that  in  the  proper  regulation  of  the  diet, 
in  the  varied  uses  of  water  as  described  in  scientific  hydrother- 
apy,  in  the  employment  of  electricity,  Swedish  movements, 
Swedish  gymnastics,  massage,  and  exercise,  together  with  gen- 
eral control  of  the  habits  of  life,  we  have  means  of  far  greater 
value  than  all  others  for  combating  those  causes  which  give 
rise  to  indigestion,  and  of  aiding  nature  in  her  efforts  for  re- 
covery from  the  varied  morbid  conditions  resulting  from  the 
numerous  disorders  commonly  included  under  the  general  term, 
"dyspepsia." 

The  man  who  is  suffering  from  indigestion  is  sick,  not  in  hi? 
stomach  alone,  but  in  every  cell  and  fiber  of  his  body ;  there  is 
no  soundness  in  him.  The  patient,  as  well  as  his  stomach,  must 


PREFACE.  5 

receive  attention.  Our  aim  must  be,  not  merely  to  cure  the  pa- 
tient's symptoms,  but  to  cure  the  patient  himself.  When  this 
is  done,  the  symptoms  disappear. 

Care  has  been  taken  to  give  an  accurate  and  precise  descrip- 
tion of  the  various  measures  of  treatment  suggested,  and  to  pre- 
sent them  in  such  a  manner  that  they  may  be  readily  available 
to  every  reader;  but  to  save  the  consumption  of  space  which 
would  be  necessitated  by  a  constant  repetition 'Of  the  descrip- 
tion, the  treatments  are  referred  to  by  number.  The  numbered 
paragraphs  will  be  found  in  the  chapter  between  pages  287  and 
344,  in  which  are  described  all  the  various  measures  of  treatment 
suggested  in  this  work. 

The  description  of  the  newer  methods  of  investigating  dis- 
orders of  the  stomach,  whereby  it  is  now  possible  to  apply  to 
their  study  the  exact  methods  of  chemistry  and  bacteriology, 
will,  it  is  hoped,  be  of  special  interest  to  the  reader.  It  is  in- 
deed not  saying  too  much  to  assert  that  the  nature  of  disorders  of 
digestion  may  now  be  determined  with  as  much  accuracy  as 
that  of  any  other  class  of  maladies,  and  that  the  old  method  of 
ascertaining  by  experiment  the  diet  best  adapted  to  an  indi- 
vidual case,  is  no  longer  necessary, —  at  least  where  there  are  at 
command  the  resources  afforded  by  recent  progress  in  this  branch 
of  medical  science. 

The  individual  who  wishes  to  make  use  of  this  work  as  a 
means  to  his  own  recovery,  must,  first  of  all,  carefully  read  the 
entire  work.  He  should  then  seek,  either  with  or  without  the 
aid  of  a  physician,  to  arrive  at  a  correct  diagnosis  of  his  case.  If 
possible,  the  services  of  a  skilled  physician  should  be  employed, 
a  test  meal  taken,  and  the  methods  of  examination  described  on 
pages  134,  320,  and  352,  utilized.  More  light  is  thrown  upon  the 
nature  of  digestive  disturbances  by  the  methods  of  examination 
here  referred  to,  than  from  all  other  sources  combined.  The 
nature  of  the  disorder  being  determined,  it  will  be  easy,  by  the 
aid  of  the  table  of  contents  or  the  index,  to  turn  to  the  section 
which  deals  with  this  particular  form  of  digestive  disturbance  ; 
and  then,  having  become  familiar  with  the  causes  of  the  trouble, 
and  the  means  of  preventing  its  aggravation,  such  rational 
methods  of  treatment  as  will  be  efficient,  and,  it  is  believed, 
successful  in  a  majority  of  cases,  may  be  carried  out  at  home. 

In  conclusion,  the  author  desires  to  remark  that  it  is  not  the 
purpose  of  this  book  to  undertake  to  displace  the  wise  family 


b  THE    STOMACH. 

physician,  but  rather  to  aid  and  abet  him  in  the  management  of 
a  class  of  maladies  which  requires,  perhaps  more  than  nil  others, 
the  thorough  co-operation  of  the  patient.  That  this  may  be 
secured,  it  is  necessary  that  the  patient  should  be  educated  in 
relation  to  the  nature  of  his  malady  and  the  various  methods  by 
which  he  may  render  assistance  in  his  own  restoration  to  health. 
The  need  of  such  a  work  has  been  made  apparent  to  the  writer 
many  times  in  his  own  practise.  For  years  past,  his  patients 
have  been  constantly  demanding  a  manual  which  should  consti- 
tute, to  some  degree  at  least,  a  guide  to  them  in  their  efforts  to 
recover  a  healthy  digestion  ;  and  it  is  hoped  that  this  little  work 
will  be  found  to  give  the  information  which  every  sufferer  from 
indigestion  ought  to  have,  and  which  every  busy  general  practi- 
tioner cannot  but  be  glad  to  have  his  patients  suffering  from  this 
class  of  disorders,  possess. 

A  number  of  cuts,  some  of  which  are  original,  and  several 
plates,  have  been  added  to  the  text,  which  it  is  hoped  will  aid 
in  giving  the  reader  a  clear  idea  of  the  subject  presented. 

,T.  n.  K. 

Battle  Creek,  Mich. 


TABLE  OF  CONTENTS. 


PAGE. 

THE    STOMACH  :    ITS    DISORDERS    AND    HOW    TO 

CURE  THEM 17 

Modern  researches  —  Germs  and  indigestion  —  Pepsin 
and  patent  medicines  —  Relation  of  dyspepsia  to  insan- 
ity and  other  disorders. 

THE  ORGANS  OF  DIGESTION 21 

The  healthy  stomach  —  The  alimentary  canal  —  The 
mouth  —  The  saliva  —  Ptyalin  —  The  teeth  —  Tempo- 
rary teeth  —  Permanent  teeth  —  The  esophagus  —  The 
stomach  —  The  peptic  glands  —  The  gastric  juice  —  Pep- 
sin—  Rennin  —  The.  pylorus. —  The  small  intestine  — 
The  intestinal  juice — The  absorbents  —  The  colon  — 
The  liver  —  The  bile  —  The  pancreas  —  The  pancreatic 
juice  —  Amylopsin  —  Trypsin  —  Steapsin  —  Milk-cur- 
dling ferment. 
FOODS 31 

Animal  and  vegetable  foods  —  Plants  the  only  food-pro- 
ducers—  Food  elements  —  Classification  of  food  elements 

—  Starch  —  Sugar  —  Glucose  —  Milk  sugar  —  Albumen  — 
Casein  —  Fats  —  Salts  —  Indigestible  elements  —  Condi- 
ments —  Food  substances  —  Foods  of  animal  origin  — 
Milk  —  Cheese  —  Eggs  —  Flesh  —  Fish  and  Fowl  —  Shell- 
fish —  Oysters  —  Frogs  —  Lobsters  —  Salted  and  smoked 
meats  —  Vegetable  foods — Fruits,  grains,  and  vegetables 

—  Legumes  —  Peptogens  —  Gluten  —  Dextrin  —  The  nat- 
ural diet  of  man  —  Vegetarianism  —  Uses  of  the  several 
food  elements  —  Digestibility  of  various  foods  —  Nutri- 
tive values  of  common  food  substances. 

THE  DIGESTIVE  FLUIDS 43 

Alexis  St.  Martin  —  What  the  saliva  digests  —  What  the 
gastric  juice  digests  —  What  the  bile  digests  —  What  the 
pancreatic  juice  digests  —  What  the  intestinal  juice  di- 
gests. 
GENERAL  VIEW  OF  THE  DIGESTIVE  PROCESS      .       44 

Mastication  —  Salivary  digestion  —  Deglutition,  or  swal- 
lowing—  Stomach  digestion — Action  of  the  pylorus  — 

[7] 


8  THE   STOMACH. 

Intestinal  digestion  —  Other  uses  of  the  digestive  fluids  — 
Gastric  juice  and  bile,  antiseptics  —  Peristaltic  action 

—  Absorption  —  How  the  diaphragm  aids  absorption  — 
The  lacteals  —  The  portal  vein  —  Liver  digestion  —  <;iy- 
cogen  —  Liver  starch  —  The  two  doors,  the  liver  and  the 
kidneys  —  Breathing  and  liver  action  —  Vagaries  of  di- 
gestion—  Poison  found  in  oysters. 

THE  MALADIES  OF  THE  MODERN   STOMACH          .       55 

The  causes  of  dyspepsia  —  Conditions  of  healthy  diges- 
tion—  Causes  of  fermentation  in  the  stomach — Disin- 
fecting action  of  the  gastric  juice  —  Errors  in  diet  — 
Hasty  eating  —  Experiments  in  relation  to  salivary  diges- 
tion—  Indigestion  of  starch  —  Relation  of  maltose  to 
digestion  —  Diseased  teeth  —  Relation  of  defective  teeth 
to  indigestion  —  Microbes  of  the  mouth  —  Disinfection 
of  the  mouth  —  Giles  Corey's  dream  —  Tartar  of  the  teeth 

—  Drinking  at  meals  —  Effects  of  ice-water  —  Dr.  Beau- 
mont's experiments  upon  Alexis  St.  Martin  —  Eating  too 
frequently  —  All-gone  feeling  in  the  stomach  —  Eating 
between   meals  —  Irregularity  of   meals  —  Rhythmical 
action  of  the  intestines — Proper  number  of  meals  — 
Habits  of  ancient  nations  in  relation  to  the  number  of 
meals  —  Habits  of  modern  nations  in  relation  to  the  num- 
ber of  meals  —  Opinion  of    Dujardin-Beaumetz  —  Late 
suppers  and  six-o'clock  dinners  —  Eating  when  exhausted 

—  Effects  of  violent  exercise  upon  the  digestion  —  Rest 
before  and  after    meals — Sleeping  after   meals  —  Too 
many  varieties  of  food  at  one  meal  —  Good  and  bad  com- 
binations of  food —  Hot  and  cold  bathing  after  meals  — 
Errors  in  quantity  of  food — Overeating  —  An  extraordi- 
nary case  —  A  case  of  dilatation  of  the  stomach  —  Eating 
too  little  —  How  much  should  a  person  eat  ?  —  Regula- 
tion of  diet  —  Muscle-workers  and  brain-workers — Die- 
tetic habits  of  Dickens  and  Newton  —  The  quantity  of 
food  required  at  different  ages  —  Desserts  —  Cornaro  — 
Experiments  of  Letheby  and  Parkes  —  Diet  of  pugilists 
in  training  —  Economy  in  diet  —  Deficiency  in  necessary 
food  elements  —  Effects  of  an  impoverished  diet  —  "  Pat- 
ent flour"  and  "  family  flour" — Unwholesome  graham 
flour  —  Bogus  gluten  flours  —  Table  relating  to  indiges- 
tion of    food  elements  —  Table  showing   proportion  of 
nitrogenous  to  carbonaceous  elements  —  Proper  propor- 
tion of  nitrogenous  and  carbonaceous  elements  —  Amount 


CONTENTS.  9 

of  food  required  for  a  day's  rations —  Quality  of  food  — 
Bad  cookery  —  Fried  food  —  Uncooked  food  —  Cooking,  a 
sort  of  artificial  ripening  of  food  elements — Why  green 
fruit  and  raw  vegetables  are  indigestible  —  Imperfectly 
cooked  food  —  Decayed  foods  —  Shell-fish  —  Rapid  decay 
of  animal  tissues  after  death  —  The  true  nature  of  beef 
tea  —  Cheese  and  cholera  morbus  —  Microbes  of  milk  — 
Soft  food  —  Influence  of  soft  food  upon  the  teeth  of  cows 
and  human  beings  — Too  abundant  use  of  fats —  Decom- 
position of  fats  in  the  stomach  —  Why  butter  is  indigest- 
ible —  Why  fats  cause  biliousness  —  Why  fats  are  ren- 
dered indigestible  by  cooking  —  Why  fats  interfere  with 
the  digestion  of  other  foods — The  superior  dietetic 
value  of  nuts  —  Nut  butter  —  The  excessive  use  of  sugar 

—  Relation  of  sugar  to  fermentation  —  Influence  of  sugar 
upon  the  stomach  and  liver  —  Why  the  excessive  use  of 
sugar  causes  diabetes  and  obesity  —  Excessive  use  of  flesh 
food  —  Relation  of  meat  diet  to  rheumatism,  gout,  and 
Bright's  disease  —  Danger  in  the  use  of  raw  meat  —  Con- 

'  diments  —  Beaumont's  observations  of  the  effects  of  con- 
diments upon  St.  Martin  —  The  excessive  use  of  mustard 
and  pepper  in  Mexico,  and  the  results  —  Effects  of  salt 
upon  digestion  —  Pickles  —  Vinegar  —  Vinegar  eels  — 
Vinegar  eels  as  parasites  —  Tea  and  coffee  —  Injurious 
effects  of  tea  and  coffee  upon  digestion  —  Alcohol — Sir 
William  Roberts's  experiments — Beaumont's  experiments 

—  Tobacco — Influence  of    tobacco   upon    digestion  — 
Hard  water  —  Alkalies  —  Baking-powders  —  Perverted 
appetites  —  Adulterations  of  food  —  Unseasonable  diet  — 
Pressure  upon  the  stomach  —  Brain  work  —  Lack  of  ex- 
ercise—  Mental  impressions — Drugs—  Laxatives — Pur- 
gatives—  Mineral  waters— Sexual  abuses  —  Diseases  of 
other  organs  —  Inherited  dyspepsia — Nursing  bottles  — 
Infant    foods  —  Paregoric  —  Mrs.   Winslow's    Soothing 
Sirup  —  Worm  teas  —  Dilatation  of  the  stomach  in  chil- 
dren—  Undetermined  causes  —  Impure  water — Germs 
in  water.  * 

IMPORTANT     NEW    DISCOVERIES     RELATING     TO 

DIGESTION 130 

The  stomach-tube  —  Measuring  the  size  of  the  stomach 

—  Clapotement — The    author's    method  —  Prolapse    of 
stomach,  kidneys,  and  other  organs  —  Examination  of 
stomach  contents  —  Test   meal  —  Facts   determined  by 


10  THE    STOMACH. 

test  meal  —  Bacteriological  examination  of  the  stomach 
contents  —  Germs  of  the  stomach  —  Coefficients  —  Classi- 
fication of  stomach  disorders  —  Hyperpepsia  —  Hypo- 
pepsia  —  Apepsia  —  Simple  dyspepsia. 

SYMPTOMS  OF  DYSPEPSIA 149 

Classification  of  indigestions — Principal  symptoms  of 
indigestion  —  Symptoms  pertaining  to  the  mouth  — 
Symptoms  pertaining  to  the  throat  —  Symptoms  pertain- 
ing to  the  esophagus  —  Symptoms  pertaining  to  the 
stomach — Disturbances  of  the  motor  functions  —  The 
discharges  —  Symptoms  pertaining  to  the  rectum  — 
General  nervous  symptoms  —  Physical  signs. 

THE     SYMPTOMATIC     TREATMENT     OF     INDIGES- 
TION   155 

Uneasiness  at  the  stomach  —  Flatulence  —  Fermentation 

—  Acidity  —  Acidity   from    hyperpepsia  —  Heartburn  — 
Water-brash,  or  pyrosis  —  Nausea  —  Vomiting  —  Regur- 
gitation,  rumination,  or  merycism  —  Gripes,  or  colic  — 
Weight,  constriction,  tightness,  etc. —  Pain  —  Biliousness 

—  Appearance  of  the  tongue  —  Aphthae  —  "Throat-ail  " 

—  Sour  taste  in  the  mouth  —  Constipation — Diarrhea  — 
Backache — The  stools  —  The  urine — Dryness  of    the 
skin  —  Skin  eruptions  —  Cold   feet,  etc. —  Headache  — 
Migraine,  or  nervous  headache — Nervous  apoplexy  — 
Disturbance  of  the  circulation  —  Nocturnal  asthma  of 
indigestion  —  "Stomach  cough" — Nervous  symptoms 

—  Nervousness  —  Disturbances  of  sight,  hearing,  etc.  — 
Nervous  diseases  —  Unusual  drowsiness  — •  Sleeplessness  — 
Mental  disorders  —  Dilatation  of  the  stomach  — Prolapse 
of  the  stomach. 

TREATMENT  OF  DYSPEPSIA >.'! 

Diet  and  regimen  —  Dietetic  rules  —  Diet  tables — Diet 
List  No.  1,  aseptic  dietary  —  Diet  List  No.  2,  dry  dietary 

—  Diet  List  No.  3,  nitrogenous  dietary  —  Diet  List  No.  4, 
farinaceous  preparations  —  Diet  List  No.  5,  milk  —  Diet 
List  No.  6,  eggs  and  milk  —  Diet  List  No.  7,  easily  disin- 
tegrated foods  —  Diet  List  No.  8,  anti-fat  dietary  —  Diet 
List  No.  9,  fat  and  blood  dietary  —  Diet  List  No.  10,  fruits 
and  nuts  —  Diet  List  No.  11,  liquid  dietary  —  Diet  List  No. 
12,  fever  diet  —  Diet  List  No.  13,  unfermented  breads  — 
Diet  List  No.   14,  for    a    bottle-fed    infant  under    six 
months  of  age — Diet  List  No.  15,  for  a  teething  infant 


CONTENTS.  11 

—  Diet  List  No.  16,  for  a  child  from  one  to  five  years  of 
age  —  Diet  List  No.  17,  eating  for  strength—  Diet  List 
No.  18,  diet  for  adults  — •  Diet  List  No.  19,  for  rheumatism 
and  gout  —  Diet  List  No.  20,  for  gastritis  —  Diet  List  No. 
21,  for  constipation  —  Diet  List  No.  22,  articles  difficult 
of  digestion  —  Poods  not  easy  of  digestion — Diet  List 
No.  23,  foods  which  promote  fermentation  and  decom- 
position in  the  stomach  —  Diet  List  No.  24,  nutritive 
enemata  —  Diet  List  No.  25,  health  foods  —  Zwieback  — 
Granose  —  Granola  —  Gluten  biscuit  —  Caramel-cereal  — 
Bromose  —  Nut  meal  and  nut  butter  —  Goflo  —  Kumy 
zoon —  Flesh  food  —  Antisepsis  of  the  mouth  —  Simple 
dyspepsia  —  Acid  dyspepsia  —  Bilious  or  foul  dyspepsia, 
or  septic  indigestion  —  Painful  dyspepsia  —  Gastric 
neurasthenia,  or  nervous  dyspepsia  —  Hypopepsia  and 
apepsia  —  What  about  pepsin  '!  —  Hyperpepsia  —  Catarrh 
of  the  stomach  —  Starch  indigestion  — Intestinal  indi- 
gestion—  Torpid  liver — 'Infantile  dyspepsia  — An  im- 
portant caution  —  Chronic  catarrh  of  the  stomach  — 
Ulcer  of  the  stomach — Cancer  of  the  stomach  —  Con- 
stipation. 

REMEDIES  FOR  THE   HOME  TREATMENT  OF  DYS- 
PEPSIA           287 

The  sponge  or  hand  batli  —  The  full  bath  —  The  salt 
glow  —  The  shower  bath  —  The  rubbing  wet-sheet  — 
The  wet-sheet  pack  —  The  trunk  pack — The  hot  and 
cold  trunk  pack  —  The  wet  girdle —  Fomentation  — 
Mustard  or  turpentine  fomentation  —  Dry  heat  —  The 
foot  bath  —  The  sitz  or  hip  bath  —  The  sun  bath  —  The 
vapor  bath  —  The  hot-air  bath  —  Hot  and  cold  to  the 
spine  —  The  hot  and  cold  pour,  or  pail  douche  —  The 
hot  and  cold  full  bath  —  The  enema  —  The  coloclys- 
ter  —  The  cold  and  the  graduated  enema  —  The  laxa- 
tive enema  —  The  oil  enema  —  Oil  rubbing  —  Massage, 
kneading  —  Abdominal  massage  —  Massage  of  the 
bowels  —  Massage  of  the  stomach  —  Replacement  of 
the  viscera  —  Inspiratory  lifting  of  the  abdominal  con- 
tents —  Hacking  —  Beating  —  General  massage  —  Exer- 
cise—  Exercises  to  develop  the  abdominal  muscles  — 
Breathing  exercises  —  Chest  lifting  —  Manual  Swedish 
movements  —  For  general  debility  and  anemia  —  For 
dilatation  of  the  stomach  —  For  prolapse  of  the  stomach, 
bowels,  colon,  kidneys,  and  other  abdominal  organs  — 


12  THK    STOMACH. 

For  dyspepsia  with  dilatation  of  the  stomach  —  For 
constipation  —  The  dry  abdominal  bandage  —  The  ab- 
dominal supporter  —  Lavage  —  Hot  and  cold  lavage  of 
the  stomach  —  Charcoal  —  Charcoal  tablets —  Antiseptic 
charcoal  tablets  —  Lactic  acid  —  Hydrochloric  acid  — 
Laxatives  —  Cascara  sagrada — Aqua  salina  —  Seltzer  — 
Sulphur  —  Antiseptic  dentifrice  —  Cinnamon  solution 

—  The     Perfection     Vaporizer — Benzoin     solution  — 
Guaiac  solution  —  Subcarbonate  of  bismuth  —  Subgal- 
late  of  bismuth — Bicarbonate  of  soda  —  Local  applica- 
tions of    faradic  electricity  —  General    applications   of 
faradic  electricity  —  The  high  tension  sinusoidal  current 

—  The  low  tension  sinusoidal  current  —  Galvanization  of 
the  spine  and  abdomen  —  Galvanization  of  the  sympa- 
thetic nerve  —  The  rest-cure—  General  nutritive  treat- 
ment—  General   tonic  treatment  —  Mechanical  Swedish 
movements  —  The  vibrating  chair  —  Mechanical  knead- 
ing—  Trunk  rolling  —  Pelvis   tilting  —  Mechanical  res- 
piration—  Cannon-ball  massage  —  Water-drinking  —  The 
hunger-cure  —  Healthful  dress  —  Sleeping  —  Traveling 

—  Mental  and  moral  treatment. 

QUACKS  AND  NOSTRUMS      ....  .     :1I5 

Stoughton  Bitters  —  Brown's  Iron  Bitters  —  Hop  Bitters 

—  Hostetter's  Bitters  —  German  Bitters  —  Stomach  Bit- 
ters—  French  Absinthe  —  Vinegar  Bitters  —  Lee's  Anti- 
bilious  Pills  —  Tropic   Fruit  Laxative  —  Carter's  Little 
Liver  Pills  —  Simon's  Liver  Regulator  —  Radway's  Regu- 
lating Pills  —  Eno's  Fruit  Salt — Hamburg  Tea  —  Gar- 
field  Tea  — Holloway's  Pills  — Hamburg   Drops—  R.  V. 
Pierce's  Pleasant  Purgative  Pellets—  Dr.  Hall's  so-called 
"Secret." 

GRAPHIC  METHOD fj.12 

Explanation  of  the  Author's  Graphic  Mode  of  Repre- 
senting the  Results  of  Stomach  Work,  obtained  from  the 
Examination  of  the  Stomach  Fluid  by  the  System  of  In- 
vestigation Employed  in  the  Hygienic  and  Physiological 
Research  Laboratories  of  the  Sanitarium  at  Battle  Creek, 
Mich.,  U.  S.  A.— The  coefficients  of  digestive  work. 

INDEX  358 


LIST  OF  ILLUSTRATIONS. 


l-AGE. 

FIG.     1.— THE  SALIVARY  GLANDS 22 

FIG.     2.— THE  TEMPORARY  TEETH 23 

FIG.     3. —  THE  PERMANENT  TEETH 24 

FIG.     4.  — THE  STOMACH 25 

FIG.     5.— PEPTIC  GLAND 26 

FIG.     6. —  THE  ALIMENTARY  CANAL 27 

FIG.     7.— THE  ABSORBENTS 28 

FIG.     8. —  A.  PANCREAS;   B.  DUODENUM;   C.  SPLEEN           .  30 

FIG.    9. —  STARCH  GRANULES      ......  32 

FIG.  10. —  THE  MESENTERIC  GLANDS  AND  LACTEALS    .        .  50 

FIG.  11. —  DIAGRAM  OP  THE  CIRCULATORY  SYSTEMS          .  51 

FIG.  12. —  HUMAN  TEETH  COVERED  WITH  TARTAR       .        .  64 

FIG.  13. — HUMAN  TEETH  INJURED  BY  TARTAR        .        .  64 

FIG.  14. —  TEETH  OP  HEALTHY  Cow 101 

FIG.  15. —  TEETH  OP  Cow  FED  ON  DISTILLERY  SLOPS      .  102 

FIG.  16. —  VINEGAR  EELS 113 

FIG.  17.— YEAST 159 

FIG.  18.  — URIC  ACID  CRYSTALS 189 

FIG.  19.— SHOWER  BATH     .         .        .        .        .        .        '.  291 

FIG.  20.— SIMPLE  SHOWER  BATH    ...                        .  292 

FIG.  21.  — RUBBING  WET-SHEET          ...  293 

FIG.  22. — WET-SHEET  PACK 294 

FIG.  23.— FOMENTATION 295 

FIG.  24.— HOT  WATER-BAG 296 

FIG.  25. — SPINE  BAG 296 

FIG.  20.— FOOT  BATH 297 

FIG.  27.— THE  SITZ  BATH  TUB 298 


14:  THE  STOMACH. 

FIG.  28.— VAPOR  BATH 299 

FIG.  29.— SYPHON  SYRINGE 301 

FIG.  30.— FOUNTAIN  SYRINGE 302 

FIG.  31.— WATER  BOTTLE  AND  SYRINGE  COMBINED          .  303 

Fi<;.  32.— ARM  FLEXION 308 

FIG.  33.— ARM  EXTENSION ::o!> 

FIG.  34. —  EXERCISE  TO  STRENGTHEN  TRUNK  MUSCLES         .  :U2 

FIG.  35. — LYING,  KNEE  BENDING 3M 

FIG.  36. —  CHEST  LIFTING ::!."> 

FIG.  37. — SACRUM  BEATING 310 

FIG.  38. —  EXERCISE  FOR  ABDOMINAL  MUSCLES      .        .        .  318 

FIG.  39. — STANDING,  SIDEWAYS  BENDING  .        .        .        .  :>M> 

FIG.  40. — NATURAL  ABDOMINAL  SUPPORTER         .        .        .  :;•-'<> 

FIG.  41.— STOMACH-TUBE 321 

FIG.  42. — PERFECTION  VAPORIZER 325 

FIG.  43. —  VAPORIZER  IN  USE 325 

FIG.  44. — SINUSOIDAL  ELECTRICAL  APPARATUS  328 


LIST  OF  PLATES. 


PAGE. 

PLATE  I. —  THE  INTERNAL  ORGANS  ( colored )              Frontispiece. 
PLATE  II. —  MICRO-ORGANISMS 128 

Fig.   1.— Micrococci  arranged  in  chains  (streptococci ). 

Fig.  2.— Micrococci  in  pair.  (diplococet). 

Fig.   3. —  Micrococci  in  a  mass  or  swarm  { zooglcea ). 

Fig.  4.— Micrococci  arranged  in  groups  of  four,  found  in  the 
sputa  of  consumptive  patients. 

Fig.  5.— Micrococci  of  pneumonia. 

Fig.   6. —  Bacteria  termo,  found  in  decomposing  matter. 

Fig.   7.—  Bacteriae  termo,  magnified  4000  diameters. 

Fig.   8.—  Bacillus  subtilfe,  hay  bacillus  found  on  manure  or  in  a 
decoction  of  hay. 

Fig.   9.— Bacteria  lineola,  germs  from  stagnant  water  ;  some- 
times seen  in  slimy  masses  on  rotten  potatoes  ;  also 
found  in  well-water. 

Fig.  10.—  Bacillus  of  typhoid  fever. 

Fig.  11. —  Bacillus  of  malaria,  found  in  the  blood  in  cases  of 
malarial  fever. 

Fig  12.—  Bacillus  of  tuberculosis. 

Fig.  13!— Bacillus  of  leprosy. 

Fig.  14.—  Spirilla  undula,   found   actively   moving  in  decom- 
posing infusions. 

Fig.  15.—  Cholera  germs. 

Fig.  16.—  Spirillum  volutans,  a   germ  with   flagella,  found   in 
marsh  water. 

Fig.  17.—  Vibrio  regula,  germs  found  in  decomposing  vegetable 
matter. 

Fig.  18. —  Cladothrix  dichotoma,  common  germ  found  in   water 
containing  decomposing  animal  or  vegetable  matter. 

Fig.  19.—  Rhabdomonas  rosea,  germs  which  form  the  red-colored 
scum  on  ponds. 

Fig.  20.— A  germ  similar  to  the  preceding,  of  a  pale-red  color, 
found  in  stagnant  water. 

Fig.  21.— Germs  found  in  stagnant  water  and  in  drain  pipes. 

Fig.  23.—  Bacterium  aceti,  the  germ  which  produces  vinegar. 

Fig.  23.—  Germs  of  cholera. 

Fig.  24.—  A  germ  which  causes  fermentation. 

Fig.  25.—  Germs  of  anthrax  in  blood  from  spleen  of  mouse. 

Fig.  26.—  Germs  of  anthrax  grown  on  a  potato. 

Fig.  27.— Germs  of  anthrax  at  a  different  stage  of  growth. 

Fig.  28.—  Foul  water  germ  in  different  stages  of  growth. 

PLATE  III. —  ANIMALCULES  AND  INFUSORIA  IN  WATER        .     129 
PLATE  IV. —  DISPLACEMENTS  op  THE  STOMACH    .        .        .     133 

Fig.  1.— Visceral  displacement. 

Fig.   2.—  Displaced  viscera. 

Fig.  3.—  Results  of  corset  constriction  ( woman  of  thirty ). 

Fig    4.—  Displacements  of  spleen  and  other  viscera. 

Fig,  5.— Woman  who  had  worn  a  "  health  corset." 

Fig.   6.—  Bad  standing  corrected  ( man ). 

[15] 


16  THE    STOMACH. 


Fig.   7.—  Bad  standing  corrected  ( woman ). 

Fig.   8.—  Standing  on  one  foot  corrected. 

Fig.  9.—  Results  of  corset  constriction. 

Fig.  10.—  Displacement  of  spleen  and  other  viscera. 

Fig.  11.—  Woman  who  had  worn  a  "  health  corset." 

PLATE  V. —  GERMS  ( colored ) 18 

Fig.  1. —  Mouth   germs   found  upon  the  surface  of   a  coated 

tongue,  greatly  magnified. 
Fig.  2.—  Germs  which  cause  decay  of  the  teeth. 
Fig.  3.— Germs  found  in  the  stomach  fluid  after  a  test  meal, 

greatly  magnified. 

PLATE  VI. —  MOVEMENTS  OP  MASSAGE          ....    304 

Fig.   1.— Superficial  kneading. 

Fig.   2.—  Deep  kneading. 

Fig.   3.—  Massage  of  the  abdomen. 

Fig.   4.—  Massage  of  the  bowels. 

Fig.   5.—  Massage  of  the  stomach. 

Fig.   6. —  Replacing  of  the  viscera. 

Fig.   7. —  Inspiratory  lifting  of  the  viscera. 

Fig.   8.— Hacking. 

Fig.   9.— Beating. 

Fig.  10.— Exercise  to  strengthen  the  abdominal  organs. 

Fig.  11.—  Knees  separating  with  resistance. 

Fig.  12.—  Full  breathing. 

PLATE  VII. —  MASSAGE 384 

Fig.  1.— Trunk  rolling. 
Fig.  2.—  Vibrating  chair. 
Fig.  3.— Pelvis  tilting. 

PLATE  VIII.  — MASSAGE        . 335 

Fig.  1.—  Mechanical  kneading. 
Fig.  2. —  Cannon-ball  massage. 
Fig.  3.—  Mechanical  respiration. 

PLATE  IX. —  HEALTHFUL  AND  ARTISTIC  DRESS          .  .     342 

Fig.  1.—  Varied  Costume. 

Fig.  2.— Freedom  Waist  with  skirt. 

Fig.  3.—  Norfolk  Jacket  with  skirt  of  Business  Suit. 

Fig.  4.—  Woman's  Practical  Business  Costume. 

PLATE  X. — HEALTHFUL  DRESS         .....    343 

Figs.  5  and  6.—  Divided  Skirt  with  circular  yoke.  Knicker- 
bockers. 

Fig.  7.—  Woman's  Practical  Business  Costume,  with  skirt 
opened  in  back  to  show  divide. 

Figs.  8  and  9.— Skirt  waist. 

Fig.  10.—  Skirt  with  circular  yoke. 

Figs.  11  and  12.— Union  suit. 

PLATE  XL— GRAPHIC  METHOD  (colored  )     .  352 


THE  STOMACH: 

ITS  DISORDERS  AND  How  TO  CURE  THEM. 


SOME  years  ago,  while  calling  upon  a  professional 
friend  in  London,  a  leading  English  practitioner,  he 
remarked,  ' '  I  suppose  that  in  America  you  have  chiefly 
to  deal  with  dyspeptics."  In  reply,  I  could  not  but 
acknowledge  that  Americans  enjoyed  the  unenviable, 
but  nevertheless  deserved,  reputation  of  being  a  nation 
of  dyspeptics  ;  but  added  that  the  treatment  of  inva- 
lids in  America  was  by  no  means  so  monotonous  as 
might  seem  to  be  the  case,  for  the  reason  that  the 
general  physical  deterioration  and  vital  derangements 
occasioned  by  dyspepsia  give  rise  to  a  vast  number  of 
varied  and  complicated  ailments  which  tax  to  the  ut- 
most the  skill  and  ingenuity  of  the  practitioner. 

Indigestion,  however,  is  by  no  means  confined  to 
America.  The  special  manifestations  of  impaired 
digestion  which  are  experienced  in  the  stomach  itself, 
and  which  most  readily  attract  attention,  are  perhaps 
more  common  in  the  United  States  than  elsewhere, 
being  a  natural  result  of  the  hasty  and  disorderly  hab- 
its of  eating  so  usual  among  us.  In  England,  Aus- 
tralia, New  Zealand,  and  other  English  colonies,  while 
there  is  less  complaint  of  indigestion,  there  is,  never- 
theless, evidence  of  the  same  prevalence  of  derange- 

2  [17] 


18  THE   STOMACH. 

ments  in  the  digestive  and  nutritive  processes,  as  is 
shown  by  the  frequency  with  which  rheumatism,  gout, 
kidney  and  bladder  diseases,  and  various  nervous 
affections  are  encountered. 

Modern  researches  into  the  relations  of  various 
maladies  have  shown  that  not  only  Bright' s  disease  and 
the  other  complaints  mentioned,  but  also  pulmonary 
consumption,  jaundice,  many  affections  of  the  liver, 
typhoid  fever,  tapeworm,  malarial  disease,  organic 
diseases  of  the  spine  and  brain,  and  even  insanity,  are, 
in  a  large  proportion  of  cases,  due  either  directly  or 
indirectly  to  the  vital  disturbances  arising  from  a 
morbid  condition  of  the  stomach. 

Dyspepsia  is  unquestionably  the  foundation  of  the 
greater  share  of  all  chronic  maladies.  When  in  a 
healthy  state,  the  body  is  able  to  defend  itself,  not 
only  against  germs,  but  against  all  other  ordinary 
causes  of  disease  ;  but  the  general  vital  deterioration 
resulting  from  indigestion  weakens  the  defenses  of  the 
body  and  its  vital  resistance,  and  renders  it  a  prey 
to  every  malady. 

The  function  of  a  tissue  or  an  organ  depends  upon 
its  structure  ;  and  the  structure  of  every  cell  and  fiber 
of  the  body  is  dependent  upon  the  quality  and  quan- 
tity of  the  material  absorbed  from  the  alimentary  canal. 
A  deficient  supply  of  food  weakens  the  structure  and 
lessens  the  energy  of  the  organ.  An  excess  of  food 
overwhelms  the  tissues  with  imperfectly  oxidized  and 
toxic  substances,  whereby  their  structure  is  deteriorated, 
and  their  functions  perverted  or  retarded.  Food  con- 
taining toxic  substances  produces  in  the  body  general 
or  specific  toxic  effects.  The  same  thing  results  from 


THE    STOMACH.  19 

the  development  of  toxic  substances  in  the  alimentary 
canal  from  the  fermentation  or  putrefaction  of  food  in 
the  stomach  and  intestines. 

Pasteur,  David,  and  others  have  shown  that  the 
mouth,  the  stomach,  and  the  intestines  are  continually 
inhabited  by  a  vast  number  of  microbes  capable  of  pro- 
ducing various  acids,  poisonous  ptomains  and  toxins, 
varying  in  their  physical  and  physiological  properties, 
some  of  them  being  capable  of  producing  powerfully 
poisonous  effects.  These  poisons  exist  in  greater  or  less 
quantity;  but,  owing  to  the  poison-destroying  power  of 
the  liver  and  the  eliminative  function  of  the  kidneys, 
the  amount  at  any  time  circulating  in  the  tissues  of  a 
healthy  person  is  not  sufficient  to  produce  any  more 
deleterious  effect  than  that  gradual  deterioration  of  the 
organism  by  which  the  tissue-modifications  character- 
istic of  old  age  are  brought  about.  ^When,  however, 
diseased  conditions  of  the  stomach  or  intestines  exist, 
these  poisons  may  be  increased  to  an  enormous  degree  ; 
for  example,  Bouchard  has  shown  that  if  food  is  re- 
tained in  the  stomach  more  than  five  hours,  the  changes 
which  take  place  are  fermentative  and  putrefactive, 
rather  than  digestive.  This  explains  the  relation  dem- 
onstrated by  Bouchard  and  others  between  dilatation  of 
the  stomach  and  chronic  rheumatism,  and  the  lowered 
vital  resistance  which,  by  dyspepsia,  prepares  the  Way 
for  tubercular  disease  of  the  lungs. 

That  something  is  wrong  with  the  modern  stomach 
is  evident  from  the  great  number  of  remedies  advertised 
in  the  newspapers,  and  displayed  upon  every  druggist's 
shelves,  as  capable  of  aiding  a  weakened  stomach. 
Pepsins,  peptones  peptonoids,  and  various  digestive 


20  THE    STOMACH. 

ferments  are  manufactured  by  the  ton.  Isotwithstand- 
ing  all  these  helps,  however,  the  average  stomach  in 
civilized  lands  grows  weaker  year  by  year,  and  disorders 
growing  out  of  indigestion  multiply  with  al arming  ra- 
pidity. Many  persons  suffer  from  disorders  of  digestion 
without  being  aware  of  the  fact.  Headache,  backache, 
bladder  and  kidney  disorders,  sleeplessness,  depression 
of  spirits,  weakness,  lack  of  energy,  coldness  of  the 
extremities,  nervous  sensations  of  various  sorts,  even 
hysteria,  epilepsy,  and  insanity,  may  exist  as  the  result 
of  indigestion  without  any  suffering  in  the  >r unacl), 
or  anything  to .  suggest  to  the  patient  himself  or  to 
the  untrained  observer,  any  disorder  of  diuv>n,m.  In 
every  case  of  chronic  disease,  the  stomach  should  be 
carefully  investigated.  A  coated  tongue  is  al 
indicative  of  a  disordered  stomach.  The  same  is  true 
of  numerous  other  symptoms  from  which  many  people 
suffer,  such  as  a  bad  taste  in  the  mouth,  claim •- 
headache  after  eating,  nervous  headache,  etc. 

Indeed,  dyspepsia  is  a  malady  which  demands  the 
most  serious  attention.  This  is  especially  apparent 
when  we  recognize  the  fact  that,  of  all  chronic  ailments, 
it  is  preeminent  as  being  preventable  by  the  employ- 
ment of  proper  means.  No  disease  is  more  dependent 
upon  conditions  which  the  individual  himself  can  con- 
trol than  is  this  ;  neither  is  there  any  malady  which 
more  readily  yields  to  the  application  of  appropriate 
remedies  when  the  necessary  conditions  are  supplied. 
I  have  no  hesitancy  in  asserting  that  every  case  of 
purely  functional  disease  of  the  stomach  may  be  cured, 
provided  the  requisite  conditions  can  be  obtained. 


THE  ORGANS  OF  DIGESTION. 


The  Healthy  Stomach. — The  conditions  of  a 
diseased  stomach  cannot  be  understood  without  a  clear 
knowledge  of  the  healthy  stomach  and  its  functions. 
Digestion  is  the  process  by  which  the  food  is  dissolved 
and  rendered  capable  of  absorption  into  the  body. 
All  animals  digest,  and  even  plants  digest  by  means 
of  their  leaves.  The  following  brief  description  of  the 
digestive  process  is  largely  taken  from  a  text-book  of 
physiology  and  hygiene  by  the  author  : 1 — 

The  Alimentary  Canal. —  The  process  of  di- 
gestion is  chiefly  performed  in  a  long  tortuous  tube 
called  the  alimentary  canal,  which  is  from  twenty-five  to 
thirty  feet  in  length,  and  reaches  from  the  mouth  to 
the  lower  part  of  the  trunk. 

The  digestive  organs  consist  of  this  canal  and  other 
organs  closely  connected  with  it,  including  various 
glands.  The  latter  produce  peculiar  fluids,  by  which 
the  food  is  changed  in  several  very  remarkable  ways,  as 
we  shall  presently  learn.  The  several  organs  which 
take  part  in  the  process  of  digestion  may  be  named  as 
follows  :  — 

The  mouth,  tongue,  teeth,  salivary  glands,  esoph- 
agus, stomach,  small  intestines,  colon,  liver,  and 
pancreas.  (The  relative  position  of  the  liver,  stomach, 
and  intestines  is  well  shown  in  Plate  I.) 

i  "Second  Book  In  Physiology  and  Hygiene,"  by  J.  H.  Kellogg,  M.  D., 
published  by  the  American  Book  Company.  The  work  may  be  obtained 
from  the  Modern  Medicine  Publishing  Company,  Battle  Creek,  Mich. 

[21] 


22 


THE    STOMACH. 


The  Mouth. —  The  cavity  of  the  mouth  is  the 
expanded  upper  portion  of  the  alimentary  canal.  It 
contains  the  teeth  and  the  tongue,  and  receives  small 
ducts,  or  canals,  from  the  three  pairs  of  salivary  glands 
closely  connected  with  it.  These  glands  produce  a 
fluid  known  as  saliva.  At  the  back  part  of  the  mouth 
are  found,  one  on  each  side  of  the  tonsils,  glands  which 


FIG.  1.— THE  SALIVARY  GLANDS. 

help  to  form  the  saliva.     The  saliva  contains  an  active 
principle  known  as  ptyalin.      (Fig.  1.) 

The  Teeth. —  A  tooth  presents  three  parts  for 
examination :  the  portion  which  is  seen  above  the 
gum,  called  the  crown  ;  the  portion  which  is  embed- 
ded in  the  jaw,  called  the  root;  and  the  narrowed  por- 
tion which  joins  these  two  parts,  called  the  neck.  The 
interior  of  the  tooth  is  filled  with  a  fleshy  substance, 


ORGANS    OF    DIGESTION.  23 

the  pulp,  containing  the  blood-vessels  and  the  nerves 
which  nourish  the  tooth  and  give  it  sensibility.  The 
body  of  the  tooth  is  made  up  of  a  tissue  resembling 
bone.  The  portion  which  projects  from  the  gum  is 
covered  by  a  very  hard,  smooth  substance,  called 
enamel,  which  is  so  brittle  as  to  be  easily  broken 
by  violent  contact  with  hard  substances. 

^   4 


FIG.  2.—  THE  TEMPORARY  TEETH. 

Temporary  Teeth. —  The  teeth  which  appear  in 
infancy  and  early  childhood  are  called  temporary, 
or  milk,  teeth.  These  teeth  usually  make  their  appear- 
ance between  the  ages  of  seven  months  and  two  years. 
They  are  twenty  in  number,  and  consist,  in  each  jaw, 
of  four  front  teeth,  or  incisors,  two  cuspids,  one  on 
each  side  of  the  incisors,  and  four  molars,  or  double 
teeth,  two  on  each  side.  (Fig.  2.) 


THE    STOMACH. 


Permanent  Teeth. —  At  the  age  of  six  or  sev- 
en years  the  temporary  teeth  begin  to  give  place  to  the 
permanent  set,  which,  when  complete,  at  the  age  of 
seventeen  to  twenty,  numbers  thirty-two,  each  jaw  con- 


PIG.  3.—  THE  PERMANENT  TEETH. 

taining,  in  addition  to  those  of  the  temporary  set, 
four  small  double  teeth,  or  bicuspids,  and  two  addi- 
tional molars,  the  so-called  wisdom  teeth.  The  last 
of  the  temporary  teeth  should  give  place  to  the  perma- 
nent ones  not  later  than  the  twelfth  year.  (Fig.  3.) 


ORGANS    OF    DIGESTION.  25 

The  Esophagus. —  In  the  act  of  swallowing, 
the  food  passes  from  the  mouth  downward  through 
a  narrow  passage  about  nine  inches  in  length,  com- 
monly called  the  esophagus,  or  meat-pipe.  The  walls 
of  this  canal  are  made  up  in  part  of  muscles,  by  the 
aid  of  which  the  food  is  carried  through  it.  When 
empty,  its  sides  lie  in  contact  with  each  other.  At 
its  lower  end  a  circular  muscle  guards  the  opening 
into  the  stomach. 


FIG.  4.—  THE  STOMACH. 

The  Stomach. —  This  is  a  dilated  portion  of  the 
alimentary  canal,  somewhat  pear-shaped  in  form,  and 
capable  of  holding  from  one  to  two  quarts.  The  walls 
of  the  stomach,  like  those  of  the  entire  digestive  canal, 
are  made  up  largely  of  thin  layers  of  muscle,  by  means 
of  which  it  is  able  to  change  its  size  and  shape,  and 
so  to  act  upon  the  food  as  to  produce  a  sort  of  churn- 
ing action.  (Fig.  4.) 

The  Peptic  Glands. —  The  lining  membrane 
of  the  stomach,  when  examined  with  a  microscope, 
is  found  to  present  multitudes  of  minute  openings, 


THE   STOMACH. 


each  of  which  is  found,  on  further  examination,  to  com- 
municate with  a  narrow  tube  which  is  embedded  in  the 
wails  of  the  stomach.  This  little  pocket  is  lined  with 
minute  living  cells,  which,  during  the  digestion  of  a 
meal,  are  engaged  in  making  a  most  important  digest- 
ive fluid,  the  gastric  juice.  (Fig.  5.) 

The  Gastric  Juice. —  This  fluid  is  intensely  acid. 
The  acid  of  the  gastric  juice  is  hydrochloric  acid, 
probably  not  a  purely  chemical  acid,  but  an  organic 
hydrochloric  acid.  There  is  also  present 
a  small  amount  of  lactic  acid. 

The  gastric  juice  contains  two  digestive 
principles,  pepsin  and  rennin. 

The  Pylorus. —  Each  end  of  the 
stomach  is  guarded  by  a  circular  muscle. 
That  at  the  lower,  or  right,  end  is  known 
as  the  pylorus.  By  means  of  these  mus- 
cles, the  openings  of  the  stomach  are  kept 
tightly  closed  while  the  process  of  digest- 
ion is  going  on. 
The  Small  Intestine. —  This  portion  of  the  ali- 
mentary canal  is  about  twenty  feet  in  length,  reaching 
from  the  stomach  to  the  large  intestine,  which  it  joins 
at  the  lower  right  portion  of  the  cavity  of  the  abdo- 
men. The  walls  of  the  intestine  are  muscular,  like 
those  of  the  stomach.  Its  mucous  lining  contains 
many  glands,  which  produce  an  alkaline  digestive  fluid 
known  as  intestinal  juice ;  and  it  is  also  covered  with 
giant  cells,  which  defend  the  body  against  germs.  Dur- 
ing digestion,  the  muscular  walls  of  the  intestines  are 
in  constant  motipn.  (Fig.  6.) 


FIG.  5.— PEPTIC 
GLAND. 


ORGANS    OF    DIGESTION. 


FIG.  6.— THE  ALIMENTARY  CANAL. 


28 


THE    STOMACH. 


The  Intestinal  Juice. —  This,  the  most  compli- 
cated of  all  the  digestive  juices,  is  produced  by  the  ac- 
tion of  all  the  numerous  and  varied  glands  found  in  the 
mucous  membrane  of  the  intestines.  Being  composed 
thus  of  the  secretions  of  a  number  of  different  glands, 
it  is  of  a  compound  character,  which  especially  fits  it 
for  its  varied  functions. 

The   Absorbents. —  The   mucous   membrane  of 


FIG.  7.— THE  ABSOBBEXTS. 


the  small  intestine  contains  numerous  folds,  and  also 
peculiar  structures  for  aiding  absorption,  known  as  the 
villi.  The  villi  are  hair-like  projections  of  mucous  mem- 
brane, which  hang  out  into  the  cavity  of  the  intestine. 
Each  villus  contains  blood-vessels  and  lymph- channels. 
(Fig.  7.) 

The  Large  Intestine,  or  Colon. —  This  portion 
of  the  alimentary  canal  is  about  five  feet  in  length, 
and  is  much  larger  in  diameter  than  the  small  intes- 


OKGANS    OF    DIGESTION.  29 

tine.  It  begins  at  the  lower  right  side  of  the  abdom- 
inal cavity,  where  it  is  joined  by  the  small  intestine. 
From  this  point  the  colon  passes  upward  to  the  lower 
border  of  the  ribs,  crosses  over  to  the  left  side,  then 
passes  down  to  the  lower  left  portion  of  the  abdomen, 
and  thence  backward,  finally  terminating  in  the  rectum. 

The  Liver. —  Lying  chiefly  at  the  right  side,  just 
above  the  lower  border  of  the  ribs,  and  partly  covering 
the  stomach,  is  the  largest  gland  in  the  body,  the  liver. 
At  the  under  side  of  the  liver  is  a  sac,  or  pouch,  known 
as  the  gall-bladder,  in  which  is  stored  up  the  digestive 
fluid  formed  by  the  liver,  called  the  bile.  A  short 
canal,  or  duct,  connects  both  the  gall-bladder  and  the 
liver  with  the  small  intestine  at  a  point  a  few  inches 
below  the  stomach. 

The  Bile. —  Human  bile  is  alkaline,  somewhat 
viscid,  and  of  a  golden-brown  color  when  fresh.  When 
vomited,  bile  is  often  green  or  yellow,  as  the  result  of 
changes  produced  in  the  stomach  by  contact  with  the 
acid  gastric  juice.  The  bile  of  the  ox  is  naturally  of  a 
greenish  color. 

A  remarkable  fact  in  relation  to  the  structure  of  the 
liver  is  that  it  is  supplied  with  two  sets  of  blood-ves- 
sels. The  extra  system  of  vessels  brings  to  the  liver 
the  blood  from  the  stomach,  intestines,  and  other  diges- 
tive organs,  and  constitutes  the  portal  circulation. 

The  Pancreas. —  Just  behind  the  stomach  is 
a  long,  curiously  shaped  gland,  known  as  the  pancreas, 
which  secretes  the  pancreatic  juice. 

The  Pancreatic  Juice.— -This  is  a  fluid  much 
like  saliva.  It  is  produced  during  the  digestion  of  a 
meal,  and  is  poured  into  the  small  intestine  through  a 


30  THE    STOMACH. 

duct  which  joins  that  from  the  liver,  and  with  it  opens 
into  the  intestinal  canal  four  or  five  inches  below  the 
stomach.  (Fig.  8.) 


B 

FIG.  8.—  A.  PANCREAS  ;  B.  DUODENUM  ;  C.  SPLEEN. 

The  pancreatic  juice  contains  four  active  principles  : 
amylopsin,  trypsin,  steapsin,  and  a  milk-curdling  fer- 
ment. 

In  order  readily  to  understand  the  relation  of  the 
digestive  organs  and  their  several  digestive  fluids  to 
foods,  it  is  necessary  to  briefly  consider  the  question, 
What  are  foods  ? 


FOODS. 


THE  body  is  constantly  sustaining  losses  in  conse- 
quence of  the  vital  work  performed  by  its  various  organs. 
Foods  are  substances  which,  when  introduced  into  the 
body,  make  good  its  natural  wastes  and  losses,  and 
furnish  proper  material  for  the  repair  of  its  tissues,  or 
for  carrying  on  its  vital  processes.  These  require- 
ments are  met  by  organized  matter,  water,  and  oxygen, 
or  what  may  be  termed  solid,  liquid,  and  gaseous 
foods.  Of  these,  the  first  only  is  commonly  known 
as  food.  Liquid  foods  are  called  drinks,  all  of  them 
having  water  for  their  essential  element.  Our  atten- 
tion will  here  be  confined  to  the  consideration  of  organ- 
ized foods. 

A  poison  is  the  opposite  of  a  food.  It  not  only 
does  not  repair  wastes  and  losses,  but  interferes  with 
the  vital  processes,  disturbing  them  in  such  a  way  as 
to  occasion  sickness  and  death. 

Animal  and  Vegetable  Foods. — Man  employs 
both  animal  and  vegetable  substances  as  foods.  Some 
nations,  particularly  the  English  and  the  American, 
use  a  large  proportion  of  flesh,  and  some  barbarous 
tribes  live  almost  wholly  upon  it ;  but  the  larger  portion 
of  the  human  race  live  chiefly  upon  vegetable  foods. 
Many  millions  of  human  beings  in  India  and  other 
parts  of  Asia  never  taste  flesh  food,  considering  it  a  sin 
to  do  so. 

Plants  the  only  Food-Producers. —  Plants 
alone  possess  the  power  to  construct  living  substances 

[31] 


32 


THE    STOMACH. 


out  of  the  elements  of  the  earth  and  the  air.  Animals 
are  able  to  subsist  upon  organized  substances  only, 
so  that  a  lion,  in  dining  upon  an  antelope,  is  only  eat- 
ing at  second  hand  the  grass  and  herbs  which  the  latter 
has  eaten  ;  and  a  man,  in  eating  roast  beef,  is  taking 
at  second  hand  the  corn  upon  which  the  ox  was  fed. 
Food-  Elements. —  When  a  chemist  examines  a 
loaf  of  bread  or  a  piece  of  meat,  he  finds  it  to  be  made 
up  of  various  substances  quite  unlike  in  nature.  These 

food  elements  each  pos- 
sess peculiar  properties, 
and  are  destined  for 
different  uses  in  the 
body  when  taken  as 
food. 

Classification  of 
Food  Elements.— 
The  various  substances 
found  in  foods  may  be 

included  in  six  classes  : 
FIG.  9.-STABCH  GRANULES.  j      gtarch  .     2<     Sugar  . 

3.  Albumen  (all  albuminous  substances)  ;  4.  Fats ; 
5.  Salts  ;  6.  Indigestible  elements. 

Starch. —  This  element  is  found  only  in  vegetable 
foods.  In  a  raw  state,  starch  is  found  in  small  par- 
ticles, or  granules,  each  enclosed  in  a  woody  envelope. 
Starch  is  the  most  abundant  of  all  the  food  elements. 
(Fig.  9.) 

Sugar. —  Sugar  is  very  unlike  starch  in  its  general 
properties,  although  closely  related  to  it.  In  the 
mysterious  chemistry  of  plant  life,  the  insoluble,  taste- 
less starch  is  converted  into  this  sweet  and  extremely 


FOODS.  33 

soluble  substance.  Several  different  kinds  of  sugar 
occur  in  nature,  the  most  important  of  which  are  cane- 
sugar,  grape-sugar,  and  milk-sugar. 

Cane-sugar  is  the  sweetest  of  all  the  sugars,  and 
is  that  commonly  used  as  food.  It  is  obtained  from 
the  sugar-cane,  the  sorghum  plant,  the  beet  root,  and 
the  maple-tree.  Grape-sugar  is  found  in  most  fruits 
and  in  honey.  Milk-sugar  gives  to  milk  its  sweet- 
ness. A  sugar  resembling  grape-sugar,  called  glucose, 
is  very  extensively  manufactured  chemically,  by  boil- 
ing the  starch  of  corn  or  potatoes  with  sulphuric  acid. 
Glucose  cannot  be  considered  a  perfect  substitute  for 
natural  sugar. 

Albumen. —  The  white  of  an  egg  is  almost  pure 
albumen.  All  true  foods  contain  elements  which  in 
many  respects  resemble  albumen,  and  serve  the  same 
purposes  in  tho  body,  and  so  are  termed  albuminous 
elements.  For  convenience,  \ve  shall  apply  the  term 
albumen  to  any  or  all  of  them.  The  lean  portion  of 
flesh  and  the  casein  of  rnilk  are  forms  of  animal  al- 
bumen. All  vegetable  foods  also  contain  albumen. 
Casein,  for  example,  is  found  in  peas  and  beans,  as 
well  as  in  milk.  One  of  the  most  important  of  all  the 
albumens  is  gluten,  which  is  found  in  wheat,  rye,  and 
barley. 

Fats. —  Oil,  or  fat,  is  found  in  both  animal  and 
vegetable  foods.  The  principal  animal  fats  used  as 
food  are  butter,  lard,  suet,  and  tallow.  Vegetable  oils 
are  chiefly  derived  from  oily  fruits,  as  the  olive,  from 
nuts,  and  from  various  seeds.  A  large  quantity  of 
fat  is  found  in  corn  and  oats. 

Salts. —  When  a  portion  of  animal  or  vegetable 
3 


34  THE    STOMACH. 

food  is  burned,  there  is  left  a  residue  of  ashes,  made 
up  of  inorganic,  or  mineral,  elements.  These  are  the 
so-called  salts  of  the  food.  They  do  not  exist  in  the 
food  in  the  form  in  which  they  are  found  in  its  ashes, 
but  in  an  organized  form.  Grains  constitute  the  most 
important  source  of  salts.  Wheat,  oats,  barley,  corn, 
and  rye  contain  an  abundant  supply  of  this  element, 
as  do  the  potato  and  most  other  vegetables.  The  salts 
also  exist  in  milk  in  good  proportion. 

Indigestible  Elements. —  All  vegetable  foods  contain 
more  or  less  of  a  woody  substance,  called  cellulose. 
The  bran  of  wheat  belongs  to  this  class  of  elements. 
Cellulose  is  not  to  any  extent  digestible,  but  it  serves 
an  important  purpose  in  giving  bulk  to  the  food.  The 
connective-tissue  elements  of  flesh  foods  —  the  liga- 
ments, tendons,  etc. —  are  hard  to  digest,  and  afford 
little  or  no  nourishment. 

In  addition  to  the  several  elements  mentioned,  all 
food  substances  contain  certain  flavoring  matters. 

Condiments. —  A  condiment  is  an  article  which 
possesses  little  or  no  food  value,  but  is  added  to  food 
for  the  purpose  of  imparting  to  it  a  characteristic  flavor. 
The  condiments  most  commonly  used  in  this  country 
are  mustard,  pepper,  ginger,  spices,  pepper-sauce, 
Worcestershire  and  other  hot  sauces,  and  vinegar.  All 
condiments  possess  irritating  or  stimulating  qualities. 
They  stimulate  the  appetite,  and  act  as  whips  to  the 
stomach  and  other  digestive  organs,  and  are  for  this 
reason  injurious. 

Food  Substances.— None  of  the  several  food 
elements  which  we  have  been  considering  are,  in  any 


FOODS.  35 

proper  sense,  to  be  regarded  as  food.  An  animal  fed 
exclusively  upon  any  one  of  them  soon  acquires  such 
a  disgust  for  its  food  that  it  will  refuse  to  taste  it, 
even  though  starving,  and  sooner  or  later  dies.  Glu- 
ten is  the  only  exception  to  this  rule.  A  true  food 
contains  various  elements,  which  are  combined  in  vary- 
ing proportions  in  different  foods.  Let  us  now  briefly 
notice  some  of  the  leading  food  substances. 

Foods  of  Animal  Origin.  —  Chief  among 
animal  foods  is  milk,  the  natural  diet  of  most  young 
animals.  Milk  contains  the  different  elements  of  nu- 
trition in  proper  proportion,  and  will  sustain  life  for  an 
indefinite  period.  The  chief  albuminous  element  of 
milk  is  casein.  The  white  color  of  milk  is  due  to 
the  fact  that  it  contains  a  considerable  amount  of  fat, 
or  oil,  in  a  state  of  emulsion,  or  division  into  minute 
drops.  By  churning,  the  little  drops  are  made  to 
unite,  producing  butter.  The  ease  with  which  it  is 
digested  renders  milk  a  most  suitable  food  for  the 
young.  It  is,  indeed,  with  rare  exceptions,  a  most 
wholesome  food  for  persons  of  all  ages. 

Cheese  made  from  milk  by  adding  rennet,  which 
separates  the  casein  and  fat  from  the  whey,  undergoes 
partial  decomposition  in  the  process  of  "curing,"  and 
is  on  this  account  much  less  wholesome  than  fresh 
milk.  It  is  difficult  to  digest,  and  likely  to  interfere 
with  the  digestion  of  other  foods.  Sometimes  a  peculiar 
fermentation  takes  place  in  cheese,  which  produces 
a  very  poisonous  substance,  known  as  tyrotoxicon. 
Very  serious  and  sometimes  fatal  illness  often  results 
from  the  use  of  such  cheese.  This  poison  is  destroyed 


36  THE    STOMACH. 

by  Leat.  On  this  account  cheese  is  rendered  less 
dangerous  by  toasting,  while  at  the  same  time  it  is 
made  more  digestible. 

Eggs, —  An  egg  contains  within  itself  every  ele- 
ment needed  for  the  support  of  the  body,  and  has 
the  advantage,  when  properly  cooked,  of  being  one  of 
the  most  easily  digested  of  foods,  and  one  of  very  high 
nutritive  value.  "When  stale,  however,  eggs  are  ex- 
ceedingly deleterious,  and  wholly  unfit  for  food.  An 
egg  usually  keeps  perfectly  fresh  not  more  than  three 
or  four  days,  when  exposed  to  the  ordinary  summer 
temperature.  Eggs  laid  by  fowls  fed  upon  decaying 
meat  and  other  unwholesome  food,  are  unfit  to  cat. 

Flesh. —  The  flesh  of  the  ox,  slu-cp,  and  hog 
is  more  largely  used  as  food  in  this  and  most  other 
civilized  countries  than  any  other  kinds  of  flesh  food. 
Mutton  is  not  so  well  relished  as  beef  by  some,  but 
it  is  nearly  as  nourishing,  and  equally  as  easy  to  digest. 
Pork  contains  much  fat,  and  is  difficult  to  digest, 
besides  being  likely  to  be  diseased,  and  must  be 
regarded  as  an  inferior  food.  The  Jews  in  ancient 
times  were  forbidden  to  eat  the  flesh  of  the  hog,  and 
they  still  abstain  from  the  use  of  pork.  The  flesh  of 
deer  and  other  wild  game,  while  usually  less  tender 
than  that  of  stall-fattened  animals,  is  more  wholesome, 
if  eaten  when  fresh,  on  account  of  the  healthier  con- 
ditions of  life  which  wild  animals  usually  enjoy.  Game 
is  often  allowed  to  become  almost  putrid  before  it  is 
eaten;  such  flesh  is  exceedingly  unwholesome.  Veal, 
like  the  flesh  of  all  very  young  animals,  is  difficult 
to  digest,  and  cannot  be  recommended  as  food. 

Fish   and    Fowl. —  The  nutritive   value  of  fish 


FOODS.  37 

and  fowl  is  not  quite  equal  to  that  of  beef  or  mutton; 
but  when  properly  cooked,  they  are  relished  by  most 
persons,  and  possess  considerable  value  as  foods. 

Shell. fish  contain  very  little  nutriment,  although 
some  of  them,  oysters  in  particular,  are  in  very  great 
favor  as  table  delicacies.  All  shell-fish  are  scavengers, 
however,  and  are  sometimes  poisonous.  Frogs,  lob- 
sters, shrimps,  sea-crabs,  etc.,  are  by  many  considered 
delicate  eating,  but  cannot  be  regarded  as  really  first- 
class  foods.  The  oyster  is  easily  digested,  though  it 
does  not  possess  the  power  to  digest  itself,  nor  to  aid 
digestion  when  eaten  raw,  as  many  persons  suppose. 
The  oyster  is  a  scavenger  in  its  habits  ;  and  when  the 
beds  in  which  oysters  grow  are  located  so  as  to  be  reached 
by  the  impure  matters  carried  into  the  sea  by  the  sew- 
ers of  a  large  city,  the  oysters  sometimes  become 
diseased,  and  produce  serious  illness  when  eaten.  Ty- 
phoid fever  has  been  traced  to  the  use  of  oysters. 

Salted  and  Smoked  Meats. —  Most  kinds  of 
flesh  foods  are  preserved  by  salting.  The  process  of 
salting  hardens  the  tissues,  thus  rendering  them  diffi- 
cult to  digest.  Smoked  meats  and  fish  are  also  hard  to 
digest. 

Vegetable  Foods.  —  Vegetable  foods  are  the 
original  source  of  the  nutritive  elements  contained  in 
flesh  foods  ;  hence  we  should  expect  them  to  furnish  all 
the  elements  of  nutrition,  and  in  proper  proportions. 
This  is  the  case  with  the  best  vegetable  foods.  Veg- 
etable foods  are  usually  divided  into  three  classes  :  — 

Fruits,  Grains,  and  Vegetables. —  Fruits  comprise 
fleshy  seeds  and  seed  bearing  portions  of  plants,  such 
as  the  apple,  strawberry,  and  plum,  each  of  which 


38  THE    STOMACH. 

represents  .a  different  class  of  fruits.  Melons  and 
nuts  are  also  fruits.  Grains  comprise  those  seeds  used 
as  foods  which  are  produced  by  grass-like  plants,  as 
wheat,  oats,  rye,  barley,  corn,  and  rice.  Allied  to  this 
class  are  the  edible  seeds  of  pod-bearing  plants,  the 
chief  of  which  are  peas,  beans,  and  lentils.  Grains 
are  the  most  nourishing  of  all  foods,  and  contain  the 
elements  of  food  in  the  best  proportion.  Fruits,  grains, 
and  milk  constitute  a  perfect  dietary,  and  one  partic- 
ularly suitable  for  young  persons,  and  for  students  and 
other  brain-workers. 

Those  parts  of  plants  used  as  food,  other  than  seeds 
or  fruits,  such  as  leaves,  stems,  roots,  buds,  and  flowers, 
are  called  vegetables.  The  nutritive  value  of  vegetables 
is  much  less  than  that  of  grains.  The  potato,  one  of 
the  most  valuable  of  all  vegetables,  is  three  fourths 
water,  and  contains  only  about  two  per  cent,  of  albu- 
minous elements.  The  starch  of  vegetables  is  more 
difficult  to  digest  than  that  of  grains  and  fruits,  and  the 
large  amount  of  woody  matter  contained  in  most  vege- 
tables adds  to  their  indigestibility  ;  so  that  they  must 
be  regarded,  in  general,  as  much  inferior  to  fruits  and 
grains  as  foods. 

Peptogens. —  Certain  properties  and  elements  of 
the  food  serve  to  stimulate  the  action  of  the  glands  by 
which  the  digestive  fluids  are  produced.  For  example, 
the  quality  of  dryness  in  the  food  powerfully  excites 
the  action  of  the  saliva.  In  experiments  conducted 
by  the  author  in  the  Laboratory  of  Hygiene  of  the 
Battle  Creek  Sanitarium  (Michigan,  U.  S.  A.)  it  has 
been  proved  that  dry  food  stimulates  the  secretion  of 
saliva  more  than  four  times  as  much  as  moist  food. 


FOODS.  39 

Gluten,  albumen,  and  other  proteid  substances  stimu- 
late the  glands  of  the  stomach  to  produce  gastric  juice. 
The  same  is  true  of  dextrin.  This  fact  is  of  consid- 
erable interest,  as  it  emphasizes  the  importance  of 
thorough  mastication  of  the  food.  In  this  way  the  food 
has  mixed  with  it  an  abundant  quantity  of  saliva,  by 
whose  action  upon  the  starch,  the  dextrin  is  produced. 

The  natural  flavors  of  foods  stimulate  the  activity 
of  all  the  digestive  glands  ;  but  condiments,  such  as 
mustard,  pepper,  pepper-sauce,  and  other  substances 
which  burn  and  sting  as  they  go  down  the  throat, 
do  not  stimulate  the  secretion  of  normal  digestive 
fluid.  They  simply  provoke  resistance  and  defense, 
causing  an  abundant  flow  of  mucus  wherewith  to  pro- 
tect the  mucous  membrane  from  their  harmful  action. 

The  Natural  Diet  of  Man. —  It  is  probable 
that  the  diet  of  the  human  family  at  first  consisted 
almost  wholly  of  fruits,  grains,  milk,  and  a  few  vegeta- 
bles. History  informs  us  that  the  dietary  of  the  ancient 
Egyptians,  Assyrians,  and  the  early  Greeks  and  Ro- 
mans was  of  this  simple  character  ;  and  the  same 
diet  is  still  practically  adhered  to  by  fully  two  thirds 
of  the  inhabitants  of  the  globe.  In  densely  populated 
countries,  such  as  Japan  and  China,  the  diet  is  neces- 
sarily almost  exclusively  vegetarian.  The  peasant  class 
of  France,  Italy,  and  Spain,  and  other  continental 
European  countries,  use  flesh  so  sparingly  that  it  may 
be  said  to  be  a  luxury  rather  than  a  food  with  them. 
Human  life  and  health  can  be  well  maintained  upon 
vegetable  food. 

Uses  of  the  Several  Food  Elements. —  The 
various  food  elements  serve  different  purposes  in  the 


40  THE    STOMACH. 

body.  Sugar,  starch,  and  fat  make  adipose  tissue,  and 
in  the  form  of  fat  enter  into  the  composition  of  nearly 
all  the  tissues  of  the  body.  They  are  of  important 
service  to  the  body  in  the  production  of  heat  and  force. 
The  different  forms  of  albumen  nourish  especially  the 
brain,  nerves,  muscles,  glands,  and  other  highly  active 
tissues  of  the  body.  The  salts  are  largely  used  in 
nourishing  the  bones.  They  are  also  required  by 
the  brain  and  the  nerves,  as  well  as  by  other  tissues. 
The  indigestible  elements  give  necessary  bulk  to  the 
food. 


DIGESTIBILITY  OF  VARIOUS   FOODS. 


Hr.  Nin. 

Rice 1  00 

Sago 1  45 

Tapioca 2  .00 

Barley 2  00 

Milk,  boiled 2  00 

Milk,  raw 2  15 

Venison,  broiled 1  35 

Turkey,  roasted 2  30 

Turkey,  domestic,  boiled  2  25 

Goose,  roasted 2  30 

Lamb,  broiled 2  30 

Eggs,  hard  boiled 3  30 

Eggs,  soft  boiled 3  00 

Eggs,  fried 3  30 

Eggs,  raw. 2  00 

Eggs,  whipped 1  30 

Trout,  boiled 1  30 

Salmon,  salted,  boiled...  4  00 

Oysters,  raw 2  55 

Oysters,  stewed 3  30 

Beef,  lean,  rare  roasted...  3  00 

Beefsteak,  broiled 3  00 

Beef,  lean,  fried 4  00 

Beef,  salted,  boiled 4  15 

Pork,  roasted 5  15 

Pork,  salted,  fried 4  15, 

Mutton,  roasted 3  15 


Mutton,  broiled. 
Veal,  broiled . . . 
-Veal,  fried. . , 


Fowl,  boiled 

Duck,  roasted 

Butter,  melted 

•Cheese 

Soup,  marrow-bone. . .  _ . 

Soup,  bean 

Soup,  mutton 

Corn  and  beans,  green  . . . 

Chicken  soup,  boiled 

•Beans,  pod,  boiled 

•Bread,  wheaten 

•Bread,  corn 

Apples,  sour  and  mellow, 
raw 

Apples,  sweet  and  mel- 
low, raw 

Parsnips,  boiled 

•Beets,  boiled 

Turnips,  flat,  boiled 

Potatoes,  Irish,  boiled . . . 

'Potatoes,  Irish,  baked... 

Cabbage,  raw 

Cabbage,   boiled 


Hr.  it. 

:?  oo 
•1  00 
4  30 
4  00 

1  :;o 
:;  ::u 
a  30 

•!   15 

:$  oo 
::  :;<> 
::  1.1 
3  00 

2  30 

3  30 

::  15 

2  00 


1  30 

2  30 
::  -15 

3  30 

3  30 
2  30 
2  30 

4  30 


TABLE  SHOWING  THE  NUTRITIVE  VALUE  OF  COMMON  FOOD  SUBSTANCE'S, 


FOOD  SUBSTANCES. 

i 

H 

Jul 
< 

M 

2 
& 

M 
W 
S. 

o 

u 
w 
1 
U 

J 

h 

g 
u 

T$ 

< 

£  ' 

i 

o°l 
If 

•  J3 
0</3 
^ 

_d 

cr. 

Cellulose  . 

Ii 

if 

fi 

3  . 
Z  » 

!> 

n 

GRAINS. 
^  Wheat.  Poland.... 

61 

! 

86  R 

Mich.  White.            

!3n 

' 

T    h 

fi' 

8s-5 

••      Diehle  

i  8 

T    8 

8TJii 

65 

i  6 

84  7 

...  Rye.AVinter  

5 

6  Q 

£9  8 

«' 

| 

s-s 

*  Barley  
So.  Russian  

I4. 

o-5 

66. 

7 

2-4 

?  b 

3.8 

6.5 

§2.2 

86 

Oats.          

* 

8 

6  i 

80  I 

Corn.  Flint  

da 

68. 

4  3 

84.9 

Dent              

68 

l.\ 

84  4 

*•      Sweet  

62. 

"> 

i  K 

6.1 

83.7 

Rice            

78 

R 

ii  8 

86  q 

Millet  

ii  8 

68 

o  R 

6.9 

8'? 

Buckwheat           •  .  . 

•* 

8 

* 

s;  6 

Iceland  Moss  

16 

-a 

56. 

2.6 

Sn 

FLOUR. 
Graham..            

T  R 

6  i 

85  t 

Wheat... 

6 

6.8 

88  7 

Rye     

ii  6 

6Q 

1.6 

6.1 

84  7 

Barley  

M« 

fi 

6.3 

84.7 

Oat...       

iti 

11 

Corn. 

'  ' 

* 

'  „ 

«l  3 

Buckwheat  

8  o 

a 

•is 

85  8 

Bean  

T     a 

cn 

^fi 

88 

Pea  

J 

87  i 

4 

57 

a 

«Vs 

Arrowroot  

,r 

" 

5 

82. 

Si'5 

BREADS. 
Barley  

64.4 

.7 

1.8 

4-3 

7-4 

»1  1 

Whole  Wheat  
White 

'3- 

8.7 

60. 
46. 

6 

8 

3- 
.5 

5-3 

8. 
Q.2 

*>'.7 

54-9 

Rye 

6  I 

2 

1.5 

8.1 

17.  » 

Swedish  Speise  Brod 

i  6 

7-7 

87 

Zwieback,   White 

«  5 

.8' 

6 

Rs'» 

Rye  ... 

9-3 

67.7 

3 

6 

, 

2.1 

7.7 

8l  7 

76.8 

8 

8  s 

86.9 

18.1 

* 

5  6 

1« 

71  6 

FRESH  FRUITS. 

8<  8 

B 

1  K 

.5 

iR 

t'-7 

81.2 

6 

''  t 

8 

§.2 

ij.5 

Blackberry    .  . 

86.4 

,, 

4 

7 

66 

:      Banana    

73- 

1.9 

f. 

«.5 

-,.(,  T 

1     Cherry 

n  s 

10 

i  9 

14.5 

M  8 

Cranberry 

80.6 

.2 

M 

'5. 

4. 

2:7 

6 

4  6 

128 

10. 

78    2 

.6* 

B 

3^ 

71  a 

is; 

8c  , 

i 

14.2 

0. 

J   Pear 

83.2 

8 

a 

2 

•  3 

20.5 

*.     Prune. 

8,  -, 

a 

6 

2 

i 

.7 

7-7 

3. 

:  pium  :: 

R«    0 

.4 

3 

6 

1  r' 

.7 

9- 

0. 

Peach 

80. 

6  , 

6  4 

3-9 

8<;  7 

.5 

6,9 

876 

6 

K 

6  i 

X  Whortleberry 

•>«  i 

.8 

i  (, 

6    T 

9.3 

DRIED  FRUITS. 
Prune  

25.4 

60  a 

Pear  

10  t 

8 

o 

6  9 

27.3 

61  7 

Apple  

5.6 

2  R 

8 

•  6 

1  ;< 

«  s 

I    ft 

478 

67 

Cherry  

,    1 

i    h 

22.  Q 

49-4 

.     Raisin.... 

54  6 

.6 

7    ^ 

76    , 

66  T 

Fig  

7 

12.4 

16  7 

Date.  ...                            , 

33- 

9- 

S8 

6.4 

6-r. 

1  Chiefly  sugar  and  starch. 


[41] 


NUTKITIVK  VAI.UK  OK  CUMMUN  FOOD  SciMMJMtt.— OottfWMd. 


FOOD  SUBSTANCES. 

•• 

1  £ 

.G 
f. 

1 
s. 

6 

Cane  Sugar. 

i 

| 

I'cctose. 

Non-Nitrog.  II 
Substances.  1 

« 

J. 

j 

3 

u 

c  4 
J3 

Is 

i 

ii 

Ntrre. 
Chestnut  

7.3. 

'4    ft 

69 

3-3 

4  8 

3g  J 

Walnut  

j.a 

'5  8 

t  ft 

4-4 

88.* 

62.6 

4. 

80  T 

6.2 

f     1 

ft    r 

7  6 

«7    1 

6  5 

3  i 

i  8 

46    2 

7n« 

Cocoanut  

46.6 
24.  C 

5-6 

8. 

26.2 

35-9 

2.3 

2.9 

P.I 

5°.  S 

75-4 

20.6 

8 

72.8 

!  ' 

3  8 

VEGETABLES. 
Carrot.  

Rft  R 

.3 

9.2 

i  5 

7-9 

RedCabbagc  

.8 

-9 

10.4 

1 

>  9 

3-' 
3-3 

8  7 

WhitiS     "          

2 

2    6 

i  8 

R    2 

Rfl    r 

6 

1.4 

10.$ 

Celery  

84.1 

8 

R  i 

14.5 

Head  Lettuce  

* 

: 

8 

1.8 

4-9 

Potato  

75- 

2 

l 

6 

o  ft 

24.4 

White  Turnip  .' 

9.1 

f-  4 

Beet  ...,...:  

fir  r 

11.5 

Sugar  Beet  

71.6 

6 

ii  6 

ft  0 

.A« 

Parsnip  

82. 

2 

.6 

8 

ft  s 

Sweet  Potato  

71.8 

J7-» 

Cucumber  

8 

2. 

4. 

Asparagus  

.8 

i  6 

5.3 

Cauliflower  

\ 

9. 

87 

Melon  

90.4 

3 

2 

-3 

4. 

•  7 

»  4 

8.2 

Onion  .                      

Si*3 

I 

+, 

5.3 

1    2 

6  * 

8.5 

5 

I    2 

*  * 

fi'? 

.6 

,  i 

R 

2   8 

784 

6  A 

R 

'  9 

small 

r  ;     6 

ft  1 

«? 

57  8 

» 

j 

3  3 

-?  R 

04  I 

Beans,  field  

48  3 

3 

78   S 

55  6 

1  " 

85  a 

white.  .  .  . 

15. 

48.8 

»  8 

1   Q 

82  2 

Lima  

,A 

2    8 

8? 

String  beans  

8*7 

I 

i  a 

Lentils   

I  0 

3  9 

83  S 

8   7 

•1  ft 

MILK  AND  BUTTER. 
Mothers'  milk.  

89.1 

•9 

Milk 
Sug. 
5.4 

3.2 

-« 

66 

2    8 

3-9 

20  7 

13.8 

6 

6 

»• 

. 

^ 

8 

12.6 

86  ! 

a 

86.6 

87 

Cheese.  Stilton  

32. 

26.2 

3.3 

'•4 

3 

Skimmed  milk  

6 

3  8 

l  8 

R 

10. 

Buttermilk.  *  

88 

3  6 

s 

l. 

Milk  of  Cow  Tree 

58. 

a  8 

MEATS. 
Lean  Beef. 

18 

28. 

Lean  Mutton 

Is  i 

1 

, 

26 

18 

Veal  .  .  . 

63. 

16.5 

13  8 

•95 

Porlc  

9.8 

j  9 

61. 

Poultry  , 

3  » 

ift 

76 

White  Fish  

18.  1 

.16 

16  i 

Tft 

White  of  Egg  

78. 

2 

Yolk  of  Egg.. 

52. 

16. 

30  7 

.1 

1.9 

4*. 

V 


[42] 


THE  DIGESTIVE  FLUIDS. 


IN  studying  the  organs  of  digestion,  we  have  learned 
that  there  are  five  digestive  fluids  ;  viz.,  the  saliva,  the 
gastric  juice,  the  bile,  the  pancreatic  juice,  and  the 
intestinal  juice.  In  the  preceding  chapter  it  has  been 
shown  that  there  are  five  digestible  food  elements  ; 
viz.,  starch,  albumen,1  fats,  sugars,  and  salts.  Let  us 
now  consider  the  use  of  each  digestive  fluid  in  relation 
to  the  various  food  elements. 

Much  of  the  information  which  has  been  gained 
respecting  the  action  of  the  stomach  upon  the  food  is 
due  to  the  persevering  and  accurate  observations  of 
Dr.  Beaumont,  a  surgeon  in  the  American  army,  who, 
in  1822,  while  stationed  in  what  wras  then  known  as 
Michigan  Territory,  was  called  upon  to  take  charge 
of  the  case  of  a  young  Canadian  by  the  name  of  Alexis 
St.  Martin,  who  had  been  accidently  wounded  in  the 
side  by  the  discharge  of  a  musket  loaded  with  shot,  at  a 
distance  of  one  yard  from  his  body  A  portion  of  flesh 
as  large  as  a  man's  hand  was  torn  away  from  his  side, 
leaving  large  openings  into  both  the  stomach  and  the 
chest.  The  opening  communicating  with  the  chest  cavity 
finally  closed  up  entirely,  but  the  opening  into  the 
stomach  remained.  Immediately  after  his  recovery  it 
was  about  two  and  one  half  inches  in  diameter.  What- 
ever was  swallowed  passed  out  through  this  opening, 
making  it  necessary  for  him  to  wear  a  pad  to  close 

i  The  word  albumen  is  used  to  represent  all  the  albuminous  elements 
of  the  food,—  albumen,  gluten,  casein,  etc. 

[43] 


44  THE    STOMACH. 

the  opening.  In  time,  nature  remedied  the  difficulty 
by  growing  over  the  opening,  upon  the  inside,  a  loose 
fold  of  membrane  which  effectually  closed  it,  yet  could 
be  easily  pushed  aside,  thus  allowing  a  full  view  <  >f  the 
interior  of  the  stomach. 

Great  and  important  additions  to  our  knowledge 
of  digestion  have  been  made  recently  by  the  us-j  of  t!i3 
stomach-tube,  a  flexible  rubber  pipe,  by  means  of 
which  digesting  food  may  be  removed  from  the  stomach 
for  chemical  examination.  The  facts  thus  learned  give 
us  more  positive  and  definite  information  respecting 
the  work  of  the  stomach  and  the  digestive  proper- 
ties of  food  than  has  been  previously  possessed,  and 
throw  great  light  upon  the  hygiene  of  digestion. 

What  the  Saliva  Digests. —  A  dry  crust  of 
bread,  chewed  for  some  minutes,  becomes  sweet.  This 
is  due  to  the  fact  that  the  saliva  contains  a  peculiar 
principle  which,  when  brought  into  contact  with  boiled 
starch,  converts  it  into  malt-sugar,  or  maltose.  In  act- 
ing upon  the  starch,  the  saliva  produces  first  soluble 
starch,  then  dextrin,  and  finally  the  perfected  product, 
malt-sugar,  or  maltose.  This  conversion  into  sugar 
constitutes  the  digestion  of  starch.  It  is  essential, 
however,  that  the  starch  should  be  cooked,  as  the 
saliva  cannot  digest  raw  starch. 

What  the  Gastric  Juice  Digests. —  Pepsin, 
one  of  the  active  principles  of  the  gastric  juice,  acts 
upon  the  albuminous  elements  of  the  food,  such  as  egg- 
albumen,  the  fibrin  of  meat,  gluten  of  grains,  casein 
of  milk,  etc.  By  its  action  all  of  these  various  sub- 
stances are  converted  into  one  simple  substance,  known 
as  peptone,  which  is  readily  absorbed  into  the  blood, 


THE    DIGESTIVE    FLUIDS.  45 

while  undigested  albumen  cannot  be  absorbed  to  any 
great  extent,  and,  if  absorbed,  would  be  of  no  use  in 
the  system.  The  gastric  juice  prepares  the  food  for 
further  digestion  by  dissolving  the  substances  by  which 
the  various  elements  of  the  food  are  held  together. 

The  rennet  ferment,  or  rennin,  of  the  gastric  juice 
coagulates  the  casein  of  milk,  forming  curds,  which 
are  afterward  dissolved  in  the  gastric  juice.  The  curds 
formed  of  cow's  milk  are  much  larger  and  tougher  than 
those  formed  of  mother's  milk ;  hence  the  difficulty 
experienced  by  many  persons  in  eating  cow's  milk, 
especially  in  cases  in  which  the  stomach  is  dilated,  and 
consequently  weakened  to  such  an  extent  that  it  is  not 
able  to  break  up  the  hard  curds  thus  formed.  When 
milk  is  mixed  with  oatmeal  or  barley  gruel,  or  other 
farinaceous  substances,  the  curds  formed  are  more  brit- 
tle in  character  ;  hence  the  advantage  of  adding  oatmeal 
or  barley  water  as  a  diminuent  for  milk  in  many  cases. 
Lime-water  has  a  similar  effect,  but  its  long-continued 
use  is  objectionable. 

Carbolic  acid,  common  salt,  and  numerous  other 
substances  are  called  antiseptics,  because  they  prevent 
fermentation  or  decay.  The  gastric  juice  and  the  bile 
also  possess  this  remarkable  property.  A  dog  was 'fed 
with  putrid  meat.  On  being  killed,  an  hour  after,  the 
meat,  which  had  been  extremely  offensive,  was  appar- 
ently perfectly  fresh.  This  property  of  the  gastric 
juice  is  exceedingly  important,  as  it  prevents  decay 
or  fermentation  in  the  stomach  before  digestion  can 
take  place. 

What  the  Bile  Digests. —  Like  the  saliva  and 
the  gastric  juice,  the  bile  digests  but  a  single  one  of 


46  THE    STOMACH. 

the  digestible  food  elements.  Its  action  is  wholly  upon 
the  fatty  portions  of  the  food.  If  oil  and  water  are 
shaken  together  in  a  bottle,  they  quickly  separate 
when  the  shaking  ceases.  Gum-water  and  oil,  when 
shaken  together,  form  a  milky  mixture  in  which  the  oil 
and  the  water  do  not  separate,  and  which  may  be  diluted 
with  water  the  same  as  milk.  The  bile  acts  upon  fats 
in  the  same  manner.  Such  a  mixture  is  called  an 
emulsion.  Under  a  microscope,  the  oil  of  an  emulsion 
is  seen  to  be  divided  up  into  very  fine  drops,  or 
globules. 

What  the  Pancreatic  Juice  Digests. —  The 
pancreatic  juice  digests  each  of  the  three  principal  food 
elements,  —  starch,  albumen,  "and  fats.  Amylopsin 
converts  starch  into  sugar,  trypsin  changes  albumen 
into  peptone,  and  steapsin  makes  an  emulsion  of  the 
fats.  The  pancreatic  juice  thus  does  the  work  of  all 
three  of  the  preceding  digestive  fluids, — the  saliva, 
the  gastric  juice,  and  the  bile. 

What  the  Intestinal  Juice  Digests. —  This 
fluid  possesses  but  one  characteristic  digestive  prop- 
erty, cane-sugar  being  ordinarily  digested  only  in  the 
small  intestine,  and  by  the  action  of  the  intestinal  juice. 
The  intestinal  juice  also  digests  starch,  albumen,  and 
fats,  and,  together  with  each  of  the  other  digestive 
fluids,  acts  upon  the  salts  of  the  food. 

In  herbivorous  animals,  and  to  a  small  extent  in 
man,  cellulose  is  digested  in  the  large  intestine. 


GENERAL  VIEW  OF  THE  DIGESTIVE 
PROCESS. 


THE  digestive  process  begins  the  moment  a  morsel 
of  food  enters  the  mouth,  and  continues  throughout 
the  entire  length  of  the  alimentary  canal,  or  until  the 
digestible  portions  of  the  food  have  'been  completely 
digested. 

Mastication. —  The  first  act  in  the  digestive  proc- 
ess is  mastication,  or  chewing,  the  purpose  of  which 
is  to  crush  the  food  and  divide  it  into  small  parti- 
cles, so  that  the  various  digestive  fluids  may  easily  and 
promptly  come  into  contact  with  every  part  of  it. 

Salivary  Digestion. —  The  saliva  softens  the 
food,  and  thus  prepares  it. for  the  action  of  the  other 
digestive  fluids.  It  also  acts  upon  the  starch,  convert- 
ing a  portion  of  it  into  sugar. 

Deglutition,  or  Swallowing. —  In  the  act  of 
swallowing,  the  food  does  not  drop  down  through  an 
open  tube,  but  is  seized  by  the  muscles  at  the  back  of 
the  mouth,  and  is  carried  down  into  the  stomach  by 
the  action  of  the  esophagus  muscles. 

Stomach  Digestion. —  Upon  receiving  the  food, 
the  stomach  very  soon  begins  to  pour  out  the  gastric 
juice,  which  first  makes  its  appearance  in  little  drops, 
like  beads  of  sweat  upon  the  face  when  the  perspi- 
ration starts.  As  the  quantity  increases,  the  drops 
run  together,  trickle  down  the  sides  of  the  stomach, 
and  mingle  with  the  food.  The  muscular  walls  of  the. 

[47] 


48  THE    STOMACH. 

stomach  contract  upon  the  food,  moving  it  about  with  a 
sort  of  churning  action,  thoroughly  mixing  the  gastric 
juice  with  the  food.  During  this  process  both  the 
openings  of  the  stomach  are  tightly  closed.  The  gas- 
tric juice  softens  the  food,  digests  albumen,  and  coagu- 
lates milk.  The  saliva  continues  its  action  upon  starch 
for  half  an  hour  after  the  food  reaches  the  stomach. 
This  action  of  the  saliva  is  highly  important  to  the  proc- 
ess of  digestion.  It  depends,  of  course,  upon  the 
thoroughness  with  which  the  food  is  masticated.  If 
the  food  is  swallowed  hastily,  it  will  contain  but  little 
saliva,  and  consequently  very  little  starch  will  be  con- 
verted into  dextrin  and  maltose,  or  sugar  ;  and  the 
person  will  suffer  from  starch  indigestion. 

Action  of  the  Pylorus. —  After  the  food  has 
remained  in  the  stomach  from  one  to  three  hours,  or 
even  longer,  if  the  digestion  is  slow  or  indigestible 
foods  have  been  eaten,  the  contractions  of  the  stomach 
become  so  vigorous  that  the  more  fluid  portions  of  the 
food  are  squeezed  out  through  the  pylorus,  thus  escap- 
ing into  the  intestine.  The  pylorus  does  not  exercise 
a  species  of  intelligence  in  the  selection  of  the  food, 
as  was  once  supposed.  The  increasing  acidity  of  the 
contents  of  the  stomach  causes  its  muscular  walls  to 
contract  with  increasing  vigor,  until  finally  those  por- 
tions of  the  food  which  may  be  less  perfectly  broken 
up,  and  which  the  stomach  has  been  unable  to  digest, 
are  forced  through  the  pylorus. 

Intestinal  Digestion.  —  As  it  leaves  the  stom- 
ach, the  mass  of  partially  digested  food  is  intensely 
acid,  from  the  large  quantity  of  gastric  juice  which  it 
contains.  Intestinal  digestion  cannot  begin  until  the 


DIGESTIVE    PROCESS.  49 

mass  becomes  alkaline.  The  alkaline  bile  neutralizes 
the  gastric  juice,  and  renders  the  digesting  mass  slightly 
alkaline.  The  bile  also  acts  upon  the  fats  of  the  food, 
converting  them  into  an  emulsion.  The  pancreatic 
juice  converts  the  starch  into  sugar,  digesting  both  raw 
-and  cooked  starch.  It  also  digests  fats  and  albumen. 
The  intestinal  juice  continues  the  work  begun  by  the 
other  digestive  fluids,  and  digests  cane-sugar. 

Other  Uses  of  the  Digestive  Fluids. —  In 
addition  to  the  uses  which  have  already  been  men- 
tioned, several  of  the  digestive  fluids  possess  other 
interesting  properties.  The  saliva  aids  the  stomach 
by  stimulating  its  glands  to  make  gastric  juice.  The 
gastric  juice  and  the  bile  are  excellent  antiseptics,  by 
which  the  food  is  preserved  from  fermentation  while 
undergoing  digestion.  The  bile  also  stimulates  the 
movements  of  the  intestines,  by  which  the  food  is  moved 
along,  and  aids  absorption.  It  is  a  remarkable  and 
interesting  fact  that  a  fluid  so  useful  as  the  bile  should 
be  at  the  same  time  largely  composed  of  waste  matters 
which  are  being  removed  from  the  body.  This  is  an 
illustration  of  the  wonderful  economy  shown  by  nature 
in  her  operations. 

Peristaltic  Action. —  The  food  is  moved  along 
the  alimentary  canal,  from  the  stomach  downward, 
by  successive  contractions  of  the  muscular  walls  of  the 
intestines,  known  as  peristaltic  movements,  which  occur 
with  great  regularity  during  digestion. 

Absorption.-  The  absorption  of  the  food  begins 
as  soon  as  any  portion  has  been  digested.  Even  in  the 
mouth  and  the  esophagus  a  small  amount  is  absorbed. 
The  entire  mucous  membrane  lining  the  digestive  canal 
is  furnished  with  a  rich  supply  of  blood-vessels,  by 
4 


50  THE    STOMACH. 

which  the  greater  part  of  the  digested  food  is  absorbed. 
Absorption  is  greatly  aided  by  a  rhythmical  contrac- 
tion of  the  villi,  which  is  in  effect  a  sort  of  pumping 
action,  alternately  filling  and  emptying  the  lacteal  and 
venous  absorbents.  The  action  of  the  diaphragm  in 
normal  breathing  also  aids  absorption  by  emptying  the 
blood-vessels  of  the  stomach  and  intestines.  During 
absorption,  the  digested  food  is  changed  into  blood. 


FIG.  10.—  THE  MESEXTERIC  GLAXDS  AXD  LACTEAIS. 

The  Lacteals. —  The  walls  of  the  intestines  con- 
tain certain  small  vessels,  called  lacteals,  on  account 
of  their  white  appearance  after  a  meal.  This  appear- 
ance is  due  to  the  digested  fat  which  they  contain,  and 
which  it  is  their  special  duty  to  absorb.  The  small 
lacteal  vessels  unite  to  form  larger  ones,  all  joining  at 
last  in  one  large  duct  about  the  size  of  a  crow's  quill, 
called  the  thoracic  duct,  which  passes  upward,  and 
necta  with  the  large  vein  which  returns  t&§  blQQ.4 
tfee  left  arm,  (Fig.  10,) 


DIGESTIVE    PROCESS. 


51 


The  Portal  Vein. —  The  veins  of  the  stomach, 
intestines,  pancreas,  and  spleen  all  unite  to  form  one 
large  vein,  called  the  portal  vein.  Instead  of  empty- 
ing, as  do  the  other  veins,  into  the  large  vein  which  goes 
to  the  heart,  the  portal  vein  conveys  its  blood  to  the 
liver,  through  which  it  is  distributed  by  a  special  set 
of  vessels.  Afterward  it  is  gathered  up  by  another 
large  vein,  and  carried  to  the  heart.  Thus  it  appears 
that  all  of  the  food  absorbed  by  the  blood-vessels  of 
the  stomach  and  intes- 
tines, constituting  the 
greater  part  of  what  is 
digested,  is  carried  to 
the  liver  before  entering 
the  general  circulation. 
(Fig.  11.) 

Liver  Digestion.— 
The  liver  not  only  secretes 
a  digestive  fluid,  the  bile, 
but  it  acts  upon  the  food 
brought  to  it  by  the  portal 
vein,  and  regulates  the 
supply  of  digested  food  to  the  general  system.  It 
converts  a  large  share  of  the  grape-sugar  and  par- 
tially digested  starch  brought  to  it  into  liver-starch, 
commonly  termed  glycogen,  which  it  stores  up  in  its 
tissues.  During  the  interval  between  the  meals,  the 
liver  gradually  redigests  the  glycogen,  reconverting  it 
into  sugar,  and  thus  supplying  it  to  the  blood  in  small 
quantities,  instead  of  allowing  the  entire  amount  formed 
in  digestion  to  enter  the  circulation  at  once.  If  too 
large  an  amount  of  sugar  entered  the  blood  at  once,  the 


DIAGRAM  OF  THE  CIRCULATORY  SYSTEMO. 

FIG.  11. 


.)-J  THE    STOMACH. 

system  would  be  unable  to  use  it  all,  and  would  be 
compelled  to  get  rid  of  a  considerable  portion  through 
the  kidneys. 

The  remarkable  function  by  which  the  liver  stores 
up  starch  within  its  tissues  is  usefully  employed  as  a 
means  of  protecting  the  body  from  various  poisons. 
When  arsenic,  mercury,  lead,  or  any  other  metallic 
poison  is  taken  into  the  stomach,  any  portion  absorbed 
is  carried  to  the  liver,  which  absorbs  and  retains  as 
much  as  possible  of  the  poison,  and  thus  protects  the 
rest  of  the  body.  The  liver  treats  alcohol  and  other 
narcotics  in  the  same  manner  ;  and  it  is  doubtless  for 
this  reason  that  the  liver  suffers  so  great  damage  from 
the  use  of  alcoholic  drinks,  tobacco,  and  other  narcotic 
substances. 

The  Two  Doors  — The  Liver  and  the  Kid- 
lieys. —  One  of  the  most  important  functions  of  the 
liver  is  its  poison-destroying  action.  Animal  and  veg- 
etable poisons,  whether  originating  outside  the  body  or 
within  the  stomach  and  intestines,  from  the  fermenta- 
tion and  decomposition  of  the  food  under  the  action  of 
germs,  are  in  large  part  destroyed  by  the  liver,  or  so 
modified  as  to  greatly  diminish  their  injurious  proper- 
ties. Such  portions  of  these  poisons  as  escape  through 
the  liver  must  be  carried  out  of  the  body  through  tho 
kidneys  ;  hence  the  work  of  the  liver  has  a  very  im- 
portant -relation  to  that  of  the  kidneys. 

If  the  liver  fails  to  do  its  work  properly,  the  kidneys 
are  overwhelmed  with  work,  and  are  liable  to  become 
disabled.  The  liver  and  the  kidneys  may  be  aptly  com- 
pared to  two  doors.  One  of  the  most  essential  con- 
ditions in  health,  and  even  in  life,  is  that  one  of  these 


DIGESTIVE   PROCESS.  53 

doors  should  be  constantly  shut,  and  the  other  constantly 
open.  The  liver  door  is,  in  health,  closed  against 
the  entrance  of  poisonous  substances,  while  the  kidney 
door  is  held  wide  open,  to  allow  these  substances  to 
escape  from  the  body  as  rapidly  as  possible.  If  -the 
liver  is  overwhelmed  with  poisonous  substances  in 
consequence  of  errors  in  diet,  it  fails  to  exclude  them 
all,  and  they  enter  the  circulation,  and  so  crowd  upon 
the  kidneys  that  these  organs  become  obstructed  and 
disabled  ;  and  the  liver  door  thus  being  open,  and  the 
kidney  door  partially  closed,  poisons  rapidly  accumulate 
within  the  body,  and  the  most  disastrous  effects  follow. 
It  thus  clearly  appears  why  habits  of  eating  have  so 
important  a  relation  to  every  function  of  the  body. 

Breathing  and  Liver  Action.  —  The  circu- 
lation of  the  blood  through  the  liver,  and  hence  all  the 
functions  of  the  liver,  are  greatly  aided  by  the  action 
of  the  chest  and  diaphragm  in  breathing.  When  the 
chest  wall  is  lifted  outward  in  the  act  of  inspiration,  air 
is  not  only  drawn  into  the  chest,  but  blood  is  also  drawn 
toward  the  heart.  Deep  breathing  is  thus  a  very  impor- 
tant means  of  aiding  both  the  stomach  and  the  liver  in 
their  work. 

Vagaries  of  Digestion. —  The  stomachs  of  cer- 
tain persons  seem  to  be  possessed  of  marked  peculiari- 
ties, as  the  result  of  which  particular  articles  of  food 
which  agree  perfectly  well  with  most  people,  gis^e  rise 
in  them  to  very  unpleasant  symptoms,  such  as  oppres- 
sion or  burning,  headache,  and  occasionally  slight  fever. 
These  symptoms  sometimes  occur  as  the  result  of  eat- 
ing strawberries  or  honey.  They. are,  however,  much 
more  likely  to  arise  from  eating  lobsters,  oysters, 


54  THE    STOMACH. 

and  clams.  Some  people  cannot  eat  buckwheat,  and 
there  are  cases  in  which  even  oatmeal  produces  a  pecul- 
iar eruption  of  the  skin.  These  instances  are,  how- 
ever, very  rare.  The  poisonous  and  sometimes  fatal 
effepts  resulting  from  the  use  of  oysters  are  due  to  the 
constant  presence  in  these  bivalves  of  a  poison  dis- 
covered by  Brieger —  mitylotoxin. 


THE  MALADIES  OF  THE  MODERN 
STOMACH. 


OUR  forefathers  knew  comparatively  little  of  the 
pangs  of  indigestion,  or  of  the  constitutional  maladies 
which  grow  out  of  the  tissue  starvation  and  systemic 
poisoning  developed  from  derangement  of  the  digestive 
functions. 

The  Causes  of  Dyspepsia. —  An  old  German 
proverb  reads,  "As  a  man  eateth,  so  is  he."  This 
is  perhaps  a  parody  upon  a  more  ancient  proverb,  ' '  As 
a  man  thinketh,  so  is  he."  Putting  both  sayings  to- 
gether, we  may  formulate  another  equally  true,  "As  a 
man  eateth,  so  he  thinketh."  Our  bodies  are  composed 
of  what  we  eat;  nevertheless,  the  simple  eating  of  good 
food  does  not  guarantee  good  tissues,  a  healthy  body, 
a  sound  mind,  and  normal  functions.  Food  must  not 
only  be  of  proper  quality,  but  it  must  be  well  digested. 
Normal  digestion  is  performed  unconsciously.  An 
individual  who  is  conscious  of  the  working  of  his 
stomach  is  suffering  with  a  disordered  state  of  that 
organ.  The  disorder  may  be  of  any  degree,  from 
that  indicated  by  a  slight  feeling  of  weight  or  uneasi- 
ness occasioned  by  taking  a  small  excess  of  food,  to 
the  most  chronic  case  of  indigestion,  exhibiting  all  the 
most  annoying  symptoms  of  this  formidable  disease. 
We  say  formidable  disease,  not  because  it  is  often  a 
fatal  malady,  but  because  of  its  obstinacy,  which  too 
often  baffles  for  years  the  best  efforts  of  those  suffer- 

[55] 


56  THE    STOMACH. 

ing  from  its  debilitating  effects.  In  most  instances, 
unfortunately,  the  efforts  of  the  patient  and  of  his 
advisers,  though  earnest  and  persevering,  are  unavail- 
ing, because  not  well  directed.  With  this,  as  with  all 
other  diseases,  the  first  step  toward  recovery  lies  in 
the  discovery  and  removal  of  the  causes  of  the  disease. 
Having  considered  the  process  of  digestion  as  it  occurs 
in  health,  and  the  conditions  required  for  healthy  di- 
gestion, we  shall  now  be  better  able  to  appreciate  the 
influence  which  various  violations  of  the  laws  of  health 
relating  to  this  function  may  exert  upon  it. 

Healthy  digestion  depends  upon  a  maintenance  of 
the  following  conditions  in  relation  to  the  stomach  :  — 

1.  The  secretion  of  gastric  juice  in  proper  quantity 
and  of  good  quality. 

2.  The   prompt   absorption   of    the   digested   food 
substances. 

3.  Normal   muscular   activity  of   the  stomach,   by 
which  the  organ  is  emptied  of  its  contents  in  due  sea- 
son, or  by  the  end  of  two  or  three  hours  after  a  meal. 

4.  The  maintenance  of  an  aseptic  condition  of  the 
stomach;  or,  in  other  words,  a  condition  in  which  the 
stomach  is  free  from  microbes,  or  germs. 

Dyspepsia  may  result  from  a  departure  from  the 
normal  standard  in  relation  to  one  or  all  of  the  above 
conditions.  The  gastric  juice  may  be  either  deficient 
or  too  abundant.  Absorption  is  never  too  rapid,  but 
it  may  be  greatly  diminished,  as  in  gastric  catarrh. 

Muscular  activity  may  be  either  deficient  or  exces- 
sive. If  deficient,  the  food  is  retained  for  too  long  a 
time  in  the  stomach,  resulting  in  irritation  of  the 
mucous  membrane  from  too  prolonged  contact  with  the 


MALADIES    OF   THE    STOMACH.  57 

acid  gastric  juice,  and  in  some  cases  even  giving  rise 
to  ulceration.  This  delay  in  the  digestive  processes 
also  allows  opportunity  for  the  action  of  germs  upon 
the  food,  thus  causing  fermentation  and  putrefaction. 
Professor  Bouchard,  of  Paris,  has  shown  that  if  food 
is  retained  in  the  stomach  for  more  than  five  hours, 
putrefactive  changes  take  place.  Fermentation  may 
begin  much  sooner  than  this.  Muscular  action  may 
be  excessive,  0in  which  case  the  food  will  be  hurried 
out  of  the  stomach  into  the  intestines  before  the  proc- 
ess of  gastric  digestion  is  completed,  thus  giving  rise 
to  irritation  in  the  intestinal  canal  from  contact  with 
food  which  has  not  been  properly  prepared  for  the 
processes  which  occur  in  this  part  of  the  digestive 
apparatus. 

Healthy  gastric  juice  is  capable  of  keeping  the 
stomach  in  a  perfectly  aseptic  condition  ;  that  is, 
destroying  all  classes  of  germs  which  are  likely  to 
find  entrance  to  the  stomach.  If  the  gastric  juice  is 
deficient  in  quantity  or  quality,  it  may  fail  to  do  its 
work  as  a  disinfecting  agent,  so  that  germs  may 
develop  in  the  stomach,  and  becoming  embedded  in 
the  mucus  which  covers  its  lining,  permanently  estab- 
lish themselves  there.  Different  classes  of  germs  may 
thus  become  active  in  the  stomach,  either  singly  or  in 
combination.  Such  symptoms  as  acidity,  or  sour  stom- 
ach, heartburn,  coated  tongue,  a  bad  taste  in  the 
mouth,  distention  of  the  stomach,  eructations  of  gas, 
etc.,  are  due  to  the  presence  of  germs  in  the  stomach, 
and  their  action  upon  the  food  elements.  Germs  do 
not  find  lodgment  in  the  stomach  when  the  food  is 
digested  thoroughly,  and  promptly  absorbed  or  passed 


58  THE  STOMACI*. 

onward  into  the  intestine.  The  special  causes  now  10 
be  mentioned  are  more  or  less  active  as  agents  pro- 
ductive of  dyspepsia,  in  proportion  as  they  disturb 
the  essential  conditions  of  good  digestion  above 
enumerated. 

Errors  in  Diet. —  There  is  no  room  to  doubt  that 
errors  in  diet,  in  the  manner  of  eating,  or  in  quantity 
and  quality  of  food,  are  by  far  the  most  active  causes 
of  indigestion.  By  asking  a  dyspeptic  how  he  eats, 
what  he  eats,  and  when  he  eats,  it  is  usually  easy  to 
discover  the  cause  of  his  suffering  ;  and  by  inducing 
him  to  form  correct  habits  in  these  three  particulars,  a 
cure  will  be  effected  in  nine  cases  out  of  ten.  In  many 
and  perhaps  most  cases,  however,  6ther  adverse  influ- 
ences of  various  sorts  serve  to  some  extent  to  compli- 
cate the  digestive  disorder,  and  to  intensify  the  effects 
arising  directly  from  the  causes  named  ;  hence  we  shall 
not  confine  our  investigation  of  the  causes  of  indiges- 
tion to  the  class  of  causes  mentioned,  exclusively,  but 
shall  also  notice  those  which  more  remotely  operate 
in  this  direction,  first,  however,  calling  attention  to 
dietetic  errors  as  the  most  common  and  most  powerful 
causes  of  the  disease  under  consideration. 

Hasty  Eating. —  The  evils  resulting  from  hasty 
eating  may  be  enumerated  as  follows  :  — 

1.  From  deficient  mastication,  the  food  is  not  prop- 
erly divided,  so  that  the  digestive  juices  cannot  gain 
access  to  its  various  elements. 

2.  By   being   retained   in   the  mouth   too  short   a 
time,  an  insufficient  amount  of  saliva  is  mingled  with  it, 
so  that  salivary  digestion  cannot  be  properly  performed. 
As  the  saliva  is  also  a    stimulus   to   the   secretion  of 


MALADIES    OF   THE    STOMACH.  59 

gastric  juice,  stomach  digestion  must  necessarily  be 
imperfect. 

3.  Again,  if  the  food  enters  the  stomach  in  a  coarse, 
unmasticated  state,  it  may  act  as  a  mechanical  irritant  to 
the  delicate  lining  of  the  stomach,  and  thus  occasion 
congestion  and  gastric  catarrh,  one  of  the  most  common 
disorders  of  the  stomach,  and  one  which  is  often  very 
obstinate  in  its  nature. 

The  best  remedy  for  the  habit  of  hasty  mastication 
is  the  use  of  dry  food.  The  importance  of  this  is  well 
shown  by  a  series  of  experiments  conducted  by  the 
author  for  the  purpose  of  determining  the  amount  of 
saliva  produced  in  masticating  dry  food  as  compared 
with  moist  and  liquid  foods.  The  results  were  as 
follows  :  — 

A  piece  of  paraffin  chewed  for  five  minutes  pro- 
duced two  thirds  of  an  ounce  of  saliva. 

One  ounce  of  granose,  a  dry  food  prepared  from 
wheat,  increased  in  weight  to  two  ounces.  The  addi- 
tion of  pepper  and  salt  to  the  granose  slightly  decreased 
the  amount  of  saliva  produced.  The  addition  of  vine- 
gar still  further  diminished' the  secretion. 

One  ounce  of  moist  bread  chewed  for  five  minutes 
caused  the  production  of  one  ounce  of  saliva. 

One  ounce  of  raw  apple  produced  one  and  one- 
fourth  ounces. 

An  ounce  of  water  produced  but  one  tenth  .of  an 
ounce  of  saliva,  or  about  one  sixth  as  much  as  a  piece 
of  paraffin,  and  one  thirtieth  as  much  as  an  ounce  of 
granose. 

One  ounce  of  milk  was  slightly  more  active  in  pro- 
ducing saliva  than  the  same  amount  of  water. 


60  THE    STOMACH. 

An  ounce  of  pea  soup  chewed  for  five  minutes  pro- 
duced twice  as  much  saliva  as  did  water,  but  only  one 
third  as  much  as  paraffin,  and  one  tenth  as  much  as 
granose. 

The  use  of  ' '  slops, ' '  so  common  in  the  United 
States,  and  to  a  great  extent  also  in  other  countries, 
is  one  of  the  most  serious  of  dietetic  errors.  The 
American  eats  in  a  hurry,  rinses  down  his  food  with 
copious  draughts  of  tea,  coffee,  iced  water,  iced  milk, 
or  iced  tea  ;  and  in  consequence  the  salivary  glands  are 
not  stimulated  to  proper  activity,  so  that  the  amount 
of  saliva  produced  is  altogether  inadequate  to  digest 
the  starchy  elements  of  food  in  the  acid  medium  of 
the  stomach  contents,  and  the  small  amount  produced  is 
so  diluted  that  its  efficiency  is  greatly  impaired.  What 
wonder  that  starch  indigestion  is  coming  to  be  an 
almost  universal  complaint,  as  shown  by  acidity, 
eructations  of  gas,  flatulence,  and  a  great  variety  of 
stomach  disturbances,  to  escape  from  which  multi- 
tudes are  continually  swallowing  quantities  of  magnesia, 
soda,  neutralizing  cordials,  and  alkaline  mineral  wa- 
ters of  various  sorts,  together  with  malt  extracts  and 
other  digestants ! 

The  inability  to  digest  starch  is  doubtless  one  of 
the  great  causes  of  the  inordinate  consumption  of  beef 
and  other  animal  products  to  which  the  English-speak- 
ing race  has  come  to  be  addicted,  as  a  method  of 
escaping  the  pangs  of  starch  indigestion. 

The  abundant  provision  made  in  the  human  body 
for  the  digestion  of  starch, —  first,  the  saliva  ;  second, 
the  bile  and  pancreatic  juice  ;  third,  the  intestinal 
juice  ;  and  finally,  the  liver, —  is  evidence  that  nature 


MALADIES    OF   THE    STOMACH.  *  61 

intended  man  to  subsist  largely  upon  farinaceous  foods. 
The  arguments  of  the  ' '  natural  food ' '  advocates, 
who  insist  that  man  should  live  upon  fruits  and  nuts, 
are  based,  not  upon  physiological  facts,  but  upon  the 
morbid  experiences  of  the  disciples  ,of  this  doctrine. 
The  writer  had  an  opportunity,  a  year  or  two  ago,  to 
examine  the  stomach  fluid  of  one  of  the  most  earnest 
and  stalwart  advocates  of  the  fruit-and-nut  diet,  and 
the  stomach  was  found  greatly  dilated,  and  almost  com- 
pletely inert. 

I  have  cured  many  scores  of  chronic  and  very 
obstinate  cases  of  dyspepsia  by  simply  requiring  the 
patient  to  subsist  upon  a  dry  diet,  whereby  he  was 
compelled  to  thoroughly  masticate  his  food.  A  fa- 
vorite prescription  with  the  writer,  which  is  applicable 
in  most  cases  of  indigestion,  is  one  or  two  ounces  of 
dry  granose  eaten  at  the  beginning  of  each  meal. 
This  introduces  into  the  stomach  an  abundant  quantity 
of  saliva, —  probably  from  four  to  six  ounces  in  most 
cases, —  and  insures  efficient  starch  digestion. 

The  dextrin  and  maltose  produced  by  the  action 
of  the  saliva  upon  the  starch  are  exactly  what  the 
stomach  needs  to  stimulate  it  to  healthful  activity, 
whereby  a  proper  quantity  and  quality  of  gastric  juice 
will  be  produced. 

Diseased  Teeth. —  Ulceration  of  the  teeth  is 
a  very  common  ailment.  Decay  of  a  tooth  is  *exactly 
analogous  to  ulceration  in  other  parts  of  the  body. 
This  destructive  action  upon  the  teeth  is  due  to  the 
presence  of  germs  in  the  mouth,  which  produce  chem- 
ical substances  of  such  a  nature  as  to  dissolve  the 


62  THE    STOMACH. 

enamel,  and  thus  expose  the  inner  portion  of  the  teeth 
to  the  action  of  destructive  microbes. 

Defective  teeth,  by  interfering  with  the  complete 
and  thorough  mastication  of  food,  seriously  impair 
the  digestion.  On  the  other  hand,  impairment  of  di- 
gestion, with  its  consequent  perversion  of  the  secre- 
tions, is  a  very  common  cause  of  decay  in  the  teeth. 
Many  persons  suffering  from  disorders  of  digestion  can- 
not hope  to  recover  without  giving  attention  to  the 
teeth,  that  •  being  necessary  as  the  first  step  toward 
reforming  the  condition  of  the  stomach.  If  possible, 
the  natural  teeth  should  be  preserved  by  filling  when 
decayed,  and  by  such  other  measures  as  any  good 
dentist  will  recommend. 

The  microbes  harbored  by  decaying  teeth  are  swept 
into  the  stomach  in  drinking  or  eating,  and  there  set 
up  fermentative  and  putrefactive  processes,  whereby 
the  food  elements  are  converted  into  poisonous  sub- 
stances. Some  of  these  poisons  are  possessed  of  such 
strong  odors  as  to  taint  the  breath.  Decaying  teeth 
may  also  be  the  means  of  introducing  into  the  body 
such  destructive  microbes  as  the  germs  of  consump- 
tion, and  others  giving  rise  to  serious  and  even  fatal 
disease. 

Decay  of  the  teeth  is  generally  the  result  of  lack  of 
use  and  of  cleanliness.  By  the  use  of  dry  food  as  pre- 
viously stated,  the  teeth  are  polished  and  kept  free 
from  the  colonies  of  germs  which  settle  upon  them 
when  they  are  not  scoured  by  attrition  of  hard  sub- 
stances. Meat  eating  is  especially  favorable  to  the 
destruction  of  the  teeth,  Tfre  small  particles  of  meat 


MALADIES    OF   THE    STOMACH.  63 

which  collect  between  the  teeth  encourage  the  develop- 
ment of  germs  of  the  most  destructive  character.  Pres- 
ervation of  the  teeth  requires  habitual  and  scrupulous 
cleanliness.  They  should  be  thoroughly  cleansed  biefore 
and  after  each  meal, —  before  the  meal  for  the  pur- 
pose of  protecting  the  stomach  from  the  germs  which 
accumulate  in  the  mouth  from  the  air,  and  lodge  about 
the  teeth  ;  and  after  the  meal  for  the  purpose  of  remov- 
ing every  particle  of  food,  so  that  the  growth  and  devel- 
opment of  germs  which  subsist  upon  remnants  of  food 
left  behind  in  the  mouth,  shall  not  be  encouraged. 

It  is  well  to  employ  some  suitable  antiseptic  as  well 
as  a  cleansing  agent  for  the  teeth,  but  many  harmful 
substances  are  recommended  for  this  use.  The  writer 
has  had  an  antiseptic  dentifrice  prepared,  the  basis  of 
which  is  an  extract  of  the  famous  soap-tree  of  South 
America,  and  cinnamon  oil.  The  first  of  these  ingredi- 
ents is  as  cleansing  as  soap,  and  avoids  the  impurities 
and  chemical  substances  found  in  it.  Oil  of  cinnamon 
is  one  of  the  best  antiseptics,  preventing  the  growth  of 
germs  even  when  not  used  in  sufficient  quantity  actually 
to  destroy  them. 

The  rapid  decay  of  the  teeth  in  civilized  countries, 
which  is  principally  due  to  the  excessive  use  of  meats 
and  of  soft  foods,  as  mushes,  soups,  bouillons,  etc., 
has  in  our  time  led  to  a  f  till  realization  of  the  dream  of 
Giles  Corey,  who  was  put  to  death  for  witchcraft  at 
Salem  nearly  two  hundred  years  ago,  and  who  wrote  :  -=- 

"  I  saw  a  man  pull  all  his  teeth, 

It  took  him  but  a  minute  ; 
He  op'd  his  mouth  and  put  them  back; 
I  thought  'e  deuce  was  in  it." 


64  THE    STOMACH. 

The  tartar  which  sometimes  accumulates  upon 
the  teeth  is  due  to  the  action  of  germs.  Tartar  should 
never  be  allowed  to  remain, —  indeed,  the  teeth  should 
be  so  often  and  so  carefully  cleansed  as  to  prevent  the 
slightest  accumulation  of  tartar.  When  allowed  to  grow 
and  remain,  tartar  separates  the  gum  from  the  teeth, 
and  produces  an  unhealthy  state  which  often  causes  the 
loss  of  the  teeth.  Fig.  12  shows  human  teeth  on  which 
are  formations  of  tartar.  In  Fig.  13  are  shown  the  same 
teeth  with  the  tartar  removed.  The  teeth  of  Orientals, 
negroes,  and  in  fact  of  nearly  all  primitive  people,  are 


FIG.  13.—  HUMAN  TEETH  COVERED  FIG.  13.— HUMAN  TEETH  INJI-RED 

WITH  TARTAR,  BY  TARTAR. 

generally  remarkably  sound,  because  of  their  simpler 
diet  and  small  use  of  meat. 

If  the  natural  teeth  cannot  be  saved  and  made 
serviceable,  they  should  be  replaced  by  artificial  ones. 
No  one  can  hope  to  preserve  good  digestion  while 
munching  food  with  toothless  gums,  or  subsisting  on  a 
dietary  that  does  not  require  the  use  of  teeth. 

Drinking  at  Meals. —  In  addition  to  the  evils 
which  it  occasions  directly,  hasty  eating  induces  the 
drinking  of  large  quantities  of  hot  or  cold  liquids  to 
wash  the  food  into  the  stomach.  Thus  two  evils  are 
associated.  Too  much  liquid  of  any  kind  is  prejudicial 
to  digestion,  because  it  delays  the  action  of  the  gastric 


MALADIES    OF    THE    STOMACH.  65 

juice,  weakens  its  digestive  qualities,  and  overtasks  the 
absorbents.  In  case  the  fluid  is  hot,  it  relaxes  and 
weakens  the  stomach.  If  it  is  cold,  it  checks  digestion 
by  cooling  the  contents  of  the  stomach  to  a  degree  at 
which  digestion  cannot  proceed.  Few  people  are  aware 
how  serious  a  disturbance  even  a  small  quantity  of  cold 
"water,  iced  cream,  or  other  cold  substance,  will  create 
when  taken  into  a  stomach  where  food  is  undergoing 
digestion.  This  process  cannot  be  carried  on  at  a  tem- 
perature less  than  that  of  the  body,  or  about  100°  F. 
Dr.  Beaumont  observed  that  when  Alexis  St.  Martin 
drank  a  glassful  of  water  at  the  usual  temperature  of 
freshly  drawn  well-water,  the  temperature  of  the  food 
undergoing  digestion  fell  immediately  to  70°,  and  did 
not  regain  the  proper  temperature  until  after  the  lapse 
of  more  than  half  an  hour. 

Of  course  the  eating  of  very  cold  food  must  have  a 
similar  effect,  making  digestion  very  tardy  and  slow. 
If  any  drink  at  all  is  taken,  it  should  be  a  few  minutes 
before  eating,  so  as  to  allow  time  for  absorption  before 
digestion  begins.  If  the  meal  is  mostly  composed  of 
dry  foods,  a  few  sips  of  warm  or  moderately  hot  water 
will  be  beneficial  rather  than  otherwise,  taken  either  at 
the  beginning  of  the  meal  or  at  its  close.  The  habit 
of  drinking  during  the  meal  should  be  discontinued 
wholly,  and  especially  by  those  whose  digestive  powers 
are  weak.  If  the  diet  is  of  proper  quality,  and  the 
food  is  well  masticated,  there  will  be  little  inclination 
to  eat  too  much.  When  the  food  is  rendered  fiery  with 
spices  and  stimulating  condiments,  it  is  no  wonder  that 
there  is  an  imperious  demand  for  water  or  liquid  of 
some  kind  to  allay  the  irritation. 
5 


66  THE    STOMACH. 

Eating  too  Frequently. —  One  of  the  most  per- 
nicious customs  of  modern  life  is  that  of  frequent  meals. 
This  habit  is  seen  in  its  extreme  development  in  Eng- 
land, five  meals  a  day,  including  lunches,  being  there 
considered  none  too  many.  The  idea  seems  to  prevail 
that  the  stomach  must  never  be  allowed  to  become 
empty  under  any  circumstances.  In  this  country,  three 
meals  a  day  is  the  general  custom,  though  more  are 
sometimes  taken. 

Healthy  digestion  requires  at  least  five  or  six  hours, 
and  one  or  two  hours  for  rest  before  another  meal  is 
taken.  This  makes  six  hours  necessary  for  the  dis- 
posal of  each  meal.  If  ordinary  food  is  taken  at 
shorter  intervals  than  this,  the  stomach  must  suffer  dis- 
turbance sooner  or  later,  since  it  will  be  allowed  no 
time  for  rest.  Again,  if  a  meal  is  taken  before  the 
preceding  meal  has  been  digested  and  passed  from  the 
stomach,  the  portion  remaining,  from  its  long  exposure 
to  the  influence  of  warmth  and  moisture,  is  likely  to  un- 
dergo fermentation,  in  spite  of  the  preserving  influence 
of  the  gastric  juice.  Thus  the  whole  mass  of  food  is 
rendered  less  fit  for  the  nutrition  of  the  body,  and  what 
is  still  more  serious,  the  stomach  is  liable  to  suffer 
permanent  injury  from  the  acids  developed. 

Too  frequent  eating  occasions  too  long  contact  of 
the  acid  contents  of  the  stomach  with  the  gastric  juice, 
which  produces  catarrh  and  ultimately  ulceration  of  that 
organ.  Frequent  eating  is  often  resorted  to  as  a  relief 
from  what  is  commonly  termed  f aintness,  or  an  "  all 
gone ' '  feeling  in  the  stomach.  The  fact  that  eating 
gives  a  respite  from  this  sensation  is  taken  as  good 
evidence  that  it  is  the  proper  remedy  ;  but,  at  the  best, 


MALADIES    OF    THE    STOMACH.  67 

only  temporary  relief  is  obtained,  and  that  at  the  ex- 
pense of  aggravating  the  difficulty.  Food  affords  relief 
simply  by  separating  the  irritated  mucous  surfaces  of 
the  stomach,  and  diluting  its  acid  fluid.  The  proper 
remedies  for  these  unpleasant  symptoms  are  given  else- 
where in  this  work. 

Eating  between  Meals. —  This  is  a  gross  breach 
of  the  requirements  of  good  digestion.  The  habit  many 
have  of  eating  fruit,  confectionery,  nuts,  sweetmeats, 
etc.,  between  meals,  is  a  certain  cause  of  dyspepsia. 
No  stomach  can  long  endure  such  usage.  Those  who. 
indulge  in  this  manner  usually  complain  of  a  poor  appe- 
tite, and  wonder  why  they  have  no.  relish  for  their  food, 
strangely  overlooking  the  real  cause,  and  utterly  disre- 
garding one  of  the  plainest  laws  of  nature. 

This  harmful  practice  is  often  begun  in  early  child- 
hood. Indeed,  it  is  too  often  cultivated  by  mothers  and 
the  would-be  friends  of  little  ones,  who  seek  to  please 
and  gratify  them  by  presents  of  confectionery  and  other 
tidbits  of  various  sorts.  Under  such  indulgence,  it  is 
not  singular  that  so  many  thousands  of  children  annu- 
ally fall  victims  to  stomach  and  intestinal  diseases  of 
various  forms.  In  great  numbers  of  cases,  early  indis- 
cretions of  this  kind  are  the  real  cause  of  fully  developed 
dyspepsia  in  later  years.  What  a  sad  thought  that 
the  lives  of  such  persons  have  been  modified  in  their 
usefulness,  and  their  whole  characters  more  or  less 
depraved,  by  the  morbid  influence  of  disordered  di- 
gestion. 

Irregularity  of  Meals. —  Another  cause  of  dys- 
pepsia, which  is  closely  related  to  the  ones  just  men- 
tioned, is  irregularity  respecting  the  time  of  meals. 


68  THE    STOMACH. 

The  human  system  seems  to  form  habits,  and  to  be  in  a 
great  degree  dependent  upon  the  performance  of  its 
functions  in  accordance  with  the  habits  formed.  In 
respect  to  digestion  this  is  especially  observable.  .  If  a 
meal  is  taken  at  a  regular  hour,  the  stomach  becomes 
accustomed  to  receiving  food  at  that  hour,  and  is  pre- 
pared for  it.  If  meals  are  eaten  irregularly,  the  stom- 
ach is  taken  by  surprise,  so  to  speak,  and  is  never  in 
a  proper  state  of  readiness  for  the  prompt  and  perfect 
performance  of  its  work.  The  habit  which  many  pro- 
fessional and  business  men  have  of  allowing  their 
business  to  intrude  upon  their  meal  hours,  frequently 
either  wholly  depriving  them  of  a  meal  or  obliging  them 
to  take  it  an  hour  or  two  later  than  the  usual  time, 
ultimately  undermines  the  best  digestion.  The  hour  for 
meals  should  be  considered  a  sacred  one,  not  to  be 
intruded  upon  except  under  some  unusual  circumstance. 
Eating  is  a  matter  of  too  momentous  importance  to  be 
interrupted  or  delayed  by  matters  of  ordinary  business 
or  convenience-. 

The  habit  of  regularity  in  eating  should  be  culti- 
vated early  in  life.  "  Children  should  be  taught  to  be 
regular  at  their  meals,  and  to  take  nothing  between 
meals.  This  rule  applies  to  infants  as  well  as  to  older 
children.  The  practice  of  feeding  the  little  one  every 
time  it  cries,  results  in  most  serious  injury  to  its  weak 
digestive  organs.  An  infant' s  stomach,  though  it  needs 
food  at  more  frequent  intervals  than  an'adult's, —  every 
two  to  four  hours,  according  to  its  age, —  requires  the 
same  regularity  which  is  essential  to  the  maintenance 
of  healthy  digestion  in  older  persons.  The  irregularity 
usually  practiced  is  undoubtedly  one  of  the  greatest 


MALADIES    OF    THE    STOMACH.  69 

causes  of  the  large  number  of  deaths  among  infants 
from  disorders  of  the  digestive  organs  shown  by  our 
mortuary  records. 

The  action  of  the  digestive  organs,  like  that  of  all 
other  organs  of  the  body,  is  rhythmical.  The  discharge 
of  the  alimentary  residue,  which  constitutes  the  fecal 
matters,  normally  occurs  after  the  first  meal  of  the  day. 
It  is  the  result  of  the  peristaltic  movements  set  up  by 
the  introduction  of  food  into  the  stomach.  By  this 
increased  activity  of  the  alimentary  canal  the  fecal  mat- 
ters resting  in  the  upper  portion  of  the  colon  are  moved 
downward  into  the  rectum,  thereby  provoking  a  desire 
for  evacuation  of  the  bowels.  By  this  means,  the  ac- 
tivities set  up  by  each  meal  move  the  contents  of  the 
intestine  to  their  appropriate  station,  resulting,  in  healthy 
persons,  in  the  discharge  of  the  alimentary  residue  from 
the  body  at  a  stated  hour  each  day.  If  a  meal  is 
omitted,  or  if  meals  are  taken  at  irregular  hours,  this 
rhythmical  action  is  broken  up,  and  constipation  is  the 
natural  result. 

It  thus  appears  that  eating  at  too  frequent  intervals 
is  not  the  only  evil  in  the  way  of  irregularity  in  eat- 
ing. It  is  far  better,  however,  to  omit  a  meal  than  to 
introduce  into  the  stomach  a  new  supply  of  food  before 
that  already  contained  in  it  has  been  properly  digested, 
and  the  organ  given  an  opportunity  for  rest. 

The  Proper  Number  of  Meals. — The  number 
of  meals  which  should  be  taken  by  a  person  in  health 
depends  somewhat  upon  the  habits  of  the  individual, 
his  occupation,  the  number  of  hours  he  labors,  etc. 
There  is  good  reason  to  believe  that  for  a  large  pro- 
portion of  those  who  now  take  three  to  five  meals  a 


70  THE    STOMACH. 

day,  two  would  be  much  better.  According  to  Hippoc- 
rates, the  ancient  Greeks  ate  but  two  meals  a  day. 
The  same  was  true  of  the  ancient  Hebrews  and  Per- 
sians. This  is  also  the  custom  of  the  natives  of  India, 
of  South  America,  and  of  many  semi-civilized  nations. 
Among  savage  tribes,  one  meal  a  day  is  the  prevailing 
custom.  The  Eskimo  walrus  hunter  sets  out  in  his  l-ajak 
on  a  day's  hunt  at  the  break  of  day,  but  eats  nothing 
until  after  he  returns  with  his  prey,  just  before  sunset. 

The  modern  frequency  of  meals  is  the  outgrowth 
of  a  gradual  losing  sight  of  the  true  purpose  of  the 
eating  of  food,  and  of  regarding  the  gratification  of 
the  palate,  instead  of  the  nourishment  of  the  body,  the 
chief  object  to  be  attained.  That  the  system  can  be 
well  nourished  upon  two  meals  a  day  is  beyond  contro- 
versy, seeing  that  not  only  did  our  vigorous  fore- 
fathers require  no  more,  but  that  hundreds  of  persons 
in  modern  times  have  adopted  the  same  custom  without 
injury,  and  with  most  decided  benefit  to  themselves. 
Students,  teachers,  clergymen,  lawyers,  and  other  lit- 
erary and  professional  men  are  especially  benefited  by 
this  plan.  The  author  has  followed  the  plan  for  more 
than  thirty  years,  and  with  great  satisfaction  The 
special  advantages  gained  by  it  are  :  1.  The  stomach 
is  allowed  a  proper  interval  for  rest.  2.  Sleep  is  much 
more  recuperative  when  the  stomach  is  allowed  to  rest 
with  the  balance  of  the  body.  8.  Digestion  cannot 
be  well  performed  during  sleep. 

Dujardin-Beaumetz,  an  eminent  French  physician, 
Bouchard,  and  other  well-known  European  authorities, 
insist  that  seven  hours  is  the  proper  length  of  time  to 
be  allowed  for  the  digestion  of  each  meal.  If  this 


MALADIES  OF  THE  STOMACH.  71 

plan  is  followed,  seven  hours  being .  allotted  to  the  di- 
gestion of  each  meal,  and  the  proper  length  of  time 
allowed  to  elapse  before  going  to  sleep  after  the  last 
meal,  it  will  be  found  impossible  to  make  any  arrange- 
ment by  which  opportunity  can  be  secured  for  the  nec- 
essary eight  hours'  sleep  at  night.  Not  more  than  two 
meals  can  be  taken  when  a  person  complies  with  all  the 
laws  of  health. 

If  more  than  two  meals  are  suited  to  any  class,  it 
is  those  who  are  engaged  for  twelve  or  more  hours  per 
day  in  severe  mental  and  physical  labor.  Such  persons 
are  better  prepared  to  digest  a  third  meal  than  those 
whose  occupation  is  mental  or  sedentary,  and  they  may 
at  least  take  it  with  less  detriment,  though  a  third  meal 
is  not  needed,  even  for  such,  provided  the  two  meals 
are  taken  at  suitable  hours.  For  many  years,  the  prac- 
tice at  the  Battle  Creek  Sanitarium  has  been  to  furnish 
its  guests  with  two  regular  meals  daily,  the  first  at  8 
A.  M.,  the  second  at  3  p.  M.  The  employees,  num- 
bering at  the  present  writing  something  more  than  six 
hundred,  are  also  furnished  with  but  two  meals,  at  6 
A.  M.  and  1:30  P.  M.  The  universal  testimony  of  all 
who  have  become  accustomed  to  these  hours  for  eating 
is  that  more  work  and  better  work  can  be  accomplished 
than  when  three  meals  are  taken.  In  cases  requiring 
more  than  two  meals,  as  when  liquid  food  or  only 
small  quantities  of  food,  can  be  taken  at  a  time,  we 
find  it  wise  to  supply  two  minor  meals,  at  12  M. 
and  7  p.  M. 

Late  Suppers  and  Six-o'clock  Dinners.— 
Eating  late  at  night,  when  the  muscular  and  nervous 
systems  are  exhausted  by  the  labor  of  the  day,  and 


72  THE    STOMACH. 

retiring  to  rest  soon  after,  is  one  of  the  most  positive 
dyspepsia-producing  habits  of  modern  times.  A  sleep- 
ing stomach  is  a  slow  one.  Secretion  must  of  necessity 
be  deficient  in  both  quantity  and  quality,  owing  to  the 
exhausted  condition  of  the  system  ;  and  with  the  further 
obstacle  afforded  to  prompt  digestion  by  the  slowing  of 
the  vital  operations  during  sleep,  it  is  almost  impossible 
that  there  should  be  other  than  disturbed  digestion,  and 
restless  sleep  in  consequence.  It  is  under  these  cir- 
cumstances that  people  often  suffer  with  obstinate  in- 
somnia, bad  dreams,  nightmare,  and  similar  troubles, 
from  which  they  arise  in  the  morning  uurefreshed  and 
unrecuperated  by  nature's  sweet  restorer,  the  work  of 
assimilation,  by  which  repair  takes  place,  having  been 
prevented  by  the  disturbed  condition  of  the  nerves. 

No  food  ought  to  be  taken  within  four  hours  of  retir- 
ing. This  will  allow  the  stomach  time  to  get  the  work  of 
digestion  forwarded  sufficiently  to  enable  it  to  be  carried 
on  to  completion  without  disturbance  of  the  rest  of  the 
economy.  If  a  third  meal  is  taken,  it  should  be  very 
light,  preferably  consisting  of  ripe  fruit  and  simple 
preparations  of  grains.  The  custom  which  prevails  in 
many  of  the  larger  cities,  of  making  dinner  the  last 
meal  of  the  day,  eating  of  foods  the  most  hearty  and 
difficult  of  digestion  as  late  as  six  or  even  eight  o'clock, 
is  one  that  ought  to  be  discountenanced  by  physicians. 
It  should  be  tolerated  only  by  those  who  convert  night 
into  day  by  late  hours  of  work  or  recreation,  not  retir- 
ing until  near  midnight.  But  in  such  cases  a  double 
reform  is  needed,  and  so  there  can  be  no  apology 
offered  for  this  reprehensible  practice,  on  any  physio- 
logical grounds. 


MALADIES    OF    THE    STOMACH.  73 

It  should  be  remembered  that  the  process  of  diges- 
tion is  not  complete  when  the  food  leaves  the  stomach. 
Recent  observations  made  upon  a  man  having  a  fistu- 
lous  opening  at  the  junction  of  the  small  intestine  with 
the  colon,  have  shown  that  fourteen  hours  elapse  from 
the  time  food  is  eaten  until  it  enters  the  colon, 
when  the  process  of  digestion  is  completed,  the  colon 
being  chiefly  a  reservoir  where  the  digested  food  is 
retained  for  absorption. 

Eating  when  Exhausted. —  This  is  a  most 
certain  cause  of  derangement  of  digestion,  and  one  to 
which  a  very  large  number  of  cases  of  dyspepsia  may 
be  traced.  The  third  meal  of  the  day  is  almost  always 
taken  when  the  system  is  exhausted  with  the  day's 
labor.  The  whole  body  is  tired,  the  stomach  as  well  as 
other  parts  of  the  organism.  The  idea  that  by  the  tak- 
ing of  food  the  stomach  or  any  other  part  of  the  system 
will  be  strengthened,  is  a  mistake.  An  eminent  writer 
on  indigestion  says  very  truthfully,  ' '  A  tired  stomach 
is  a  weak  stomach. ' '  When  the  stomach  feels  ' '  weak 
and  faint,"  rest  is  what  is  demanded,  and  is  the  only 
thing  that  will  do  it  good  ;  yet  many  people  insist  on 
putting  more  food  into  it,  thus  compelling  it  to  work 
when  it  ought  to  be  allowed  to  remain  inactive  until 
rested.  The  arm  wearies  by  constant  exercise,  and  so 
does  the  stomach,  which,  like  the  arm,  is  active  through 
its  muscular  structure.  Both  secretion  and  muscular 
activity  are  greatly  lessened  in  a  tired  stomach,  and 
the  habitual  disregard  of  this  fact  cannot  but  be  disas- 
trous to  the  best  digestion. 

Violent  exercise  either  just  before  or  just  after  eat- 
ing is  a  hindrance  to  good  digestion.  When  the  exer- 


74  THE    STOMACH. 

cise  is  taken  just  before  the  meal,  the  stomach  is  left 
too  tired  to  do  its  work  properly  ;  and  when  taken  im- 
mediately after  eating,  the  vital  energies  are  diverted  to 
other  parts,  and  the  stomach  is  thus  robbed  of  its  nec- 
essary share.  An  English  physiologist  performed  an 
experiment  which  well  illustrates  the  truth  of  this  posi- 
tion. Having  fed  a  dog  his  usual  allowance  of  meat 
one  morning,  he  took  him  out  upon  a  fox  hunt,  and 
kept  him  racing  over  the  country  until  night,  when, 
having  killed  the  animal,  he  examined  his  stomach  at 
once,  and  found  the  meat  in  the  same  condition  in 
which  it  had  entered  the  stomach,  no  digestion  having 
taken  place.  In  another  dog,  fed  with  the  same  kind 
of  food,  but  left  quiet  at  home,  digestion  was  found  to 
be  complete. 

The  hurry  and  press  of  business  among  Americans 
-is  allowed  to  override  every  consideration  of  health. 
It  seems  never  to  enter  the  mind  of  the  average  busi- 
ness man  that  any  time  is  required  for  digestion. 
Rushing  to  his  dinner  from  the  plow,  the  workshop,  or 
the  counting-room,  he  swallows  his  food  with  all  pos- 
sible dispatch,  and  hurries  back  to  his  work  again, 
begrudging  every  moment  spent  in  meeting  the  re- 
quirements of  nature.  Many  years  ago  it  was  custom- 
ary in  Edinburgh  to  suspend  all  business  for  two  hours 
in  the  middle  of  the  day,  so  as  to  allow  ample  time  for 
meals.  A  similar  custom  once  prevailed  in  Switzer- 
land ;  but  probably  such  a  sensible  custom  is  now  con- 
sidered too  old-fashioned  to  be  tolerated. 

It  should  be  remarked  that  severe  mental  labor  im- 
mediately before  or  after  and  especially  during  meals, 
is  even  more  injurious  than  physical  employment.  The 


MALADIES    OF   THE    STOMACH.  75 

habit  many  business  men  have  of  anxiously  scanning 
the  newspapers  during  their  meals,  and  while  going  to 
and  from  their  places  of  business,  is  a  bad  one.  At 
least  a  full  hour  should  be  taken  for  the  midday  meal  ; 
and  if  an  hour's  rest  can  be  secured  before  eating,  im- 
proved digestion  will  well  repay  the  time  spent  in 
reinforcing  the  vital  energies.  For  persons  of  weak 
digestion,  the  rest  before  eating  is  alrnosif  indispen- 
sable. 

Recent  experiments  have  shown  that  the  muscular 
strength  is  increased  very  soon  after  eating.  This  must 
be  due  to  the  digestion  and  absorption  of  the  starch, 
whereby  the  muscles  are  furnished  a  frosh  supply  of 
glycogen,  which  is  their  source  of  energy.  It  is,  there- 
fore, admissable  that  a  very  small  amount  of  food 
be  taken  by  an  exhausted  person,  but  it  should  be  of  a 
kind  which  is  easily  digested,  and  the  quantity  should 
be  very  small.  Nitrogenous  food,  such  as  meat  and 
eggs,  is  especially  detrimental  to  a  person  in  this  con- 
dition. Thin,  well-boiled  gruel  or  rice  watsr,  a  little 
rice,  a  crust  of  bread  well  chewed,  a  cup  of  vegetable 
broth,  a  bunch  of  grapes,  an  orange,  or  a  bit  of  ripe 
fruit  of  some  other  kind,  are  most  suitable  for  this 
purpose. 

Sleeping  after  Meals. — While  rest  from  ac- 
customed exercise  after  eating  is  important,  it  should 
be  noted  that  sleep  at  this  time  is  equally  as  bad  as  vigor- 
ous exercise  of  either  mind  or  body.  Good  digestion 
cannot  take  place  during  sleep.  While  it  is  true  that 
digestion  is  an  involuntary  act,  it  should  be  recollected 
that  it  is  dependent  upon  the  activity  of  the  nervous 
system  for  its  proper  performance.  The  same  nerve 


76  THE    STOMACH. 

which  secures  activity  of  the  respiratory  organs, — the 
pneumogastric, — controls  the  muscular  activity  of  the 
stomach  and  the  intestines.  During  sleep,  from  the 
lessening  of  nervous  activity,  both  the  respiration  and 
the  circulation  are  greatly  lessened  in  vigor.  It  is  but 
reasonable  to  suppose  that  the  activity  of  the  digestive 
organs  is  decreased  at  the  same  time,  being  controlled 
by  the  same  nerves.  Actual  experiment  shows  this  to 
be  true.  Most  people  who  lie  down  and  sleep  an  hour 
or  two  soon  after  taking  food,  awake  feeling  anything  but 
refreshed.  The  suspension  of  the  process  to  a  consid- 
erable degree  during  sleep  causes  imperfect  digestion, 
with  its  numerous  unpleasant  symptoms.  In  the  case 
of  old  people,  it  may  sometimes  be  beneficial,  or  at 
least  not  harmful,  to  secure  a  few  minutes'  sleep  after 
eating,  before  digestion  is  well  begun  ;  but  it  must  not 
be  long  continued. 

In  order  to  secure  the  best  conditions  for  digestion 
after  eating,  an  individual  should  take  gentle  exercise 
of  some  kind,  as  walking,  or  carriage  or  horseback  rid- 
ing. While  violent  exertion  seriously  interrupts  the 
digestive  process,  a  moderate  degree  of  physical  exer- 
cise facilitates  it  by  increasing  the  activity  of  the  glands 
by  which  the  gastric  juice  is  formed.  It  is  probable 
that  gentle  exercise  also  encourages  digestion  by  stim- 
ulating the  movements  of  the  stomach. 

Too  Many  Varieties  of  Food. —  Many  dys- 
pepsias arise  from  the  eating  of  too  many  kinds  of  food 
at  the  same  meal,  another  growing  custom  of  modern 
times  which  deserves  to  be  severely  condemned.  At 
great  dinners  in  honor  of  distinguished  personages, 
when  friends  are  to  be  entertained,  and  in  the  majority 


MALADIES    OF    THE    STOMACH.  77 

of  well-to-do  families  as  a  general  custom,  the  eaters 
are  tempted  to  gluttony  by  having  presented  to  their 
palates  a  great  variety  of  complicated  dishes.  On  the 
occasion  of  the  giving  of  a  great  dinner,  more  than  a 
hundred  dishes  are  sometimes  served  in  successive 
courses.  Such  gormandizing  soon  breaks  down  the 
most  vigorous  digestive  organs,  since  it  adds  to  the 
labor  of  digesting  food  which  is  improperly  cooked,  a 
larger  variety  than  the  digestive  juices  are  capable  of 
bringing  into  a  fit  state  for  absorption. 

Food  Combinations. —  Careful  experiments  have 
shown  very  clearly  that  different  classes  of  food  require 
a  particular  quality  of  digestive  juices  for  their  diges- 
tion. For  instance,  a  gastric  juice  that  will  digest  ani- 
mal food  the  best,  is  inferior  for  the  digestion  of  vege- 
table food,  and  vice  versa.  The  obvious  conclusion  to 
be  drawn  from  this  fact  is  that  the  simpler  the  dietary, 
the  more  perfectly  will  the  digestive  process  be  per- 
formed. For  persons  whose  digestion  is  naturally 
weak  this  is  a  matter  of  especial  importance.  The  fol- 
lowing table  represents  the  best  and  worst  food  combi-. 
nations  :  — 

GOOD   COMBINATIONS. 

Grains  and  Fruits.  Grains  and  Milk. 

Grains  and  Meat,  or  Eggs.  Grains  and  Vegetables. 

FAIR   COMBINATIONS. 

Grains,  Sweet  Fruits,  and  Milk.       Meat  and  Vegetables. 

BAD   COMBINATIONS. 

Fruits  and  Vegetables.  Milk  and  Vegetables. 

Milk  and  Meat. 

Those  foods  agree  best  whose  chief  constituent  ele- 
ments are  digested  by  the  same  fluid,  in  the  same  part 


78  THE    STOMACH. 

of  the  alimentary  canal,  and  in  about  the  same  length 
of  time.  Vegetables  contain  a  great  amount  of  coarse, 
woody  structures,  which  are  retained  in  the  stomach  a 
long  time  before  they  are  sufficiently  broken  up  to  be 
easily  digested  in  the  intestines.  Fruits,  on  the  other 
hand,  remain  but  a  short  time  in  the  stomach.  The 
large  amount  of  saccharine  matter  which  fruits  contain, 
makes  them  likely  to  set  up  fermentation  in  the  stom- 
ach, if  retained  too  long.  Acid  fruits  are  also  likely 
to  delay  starch*  digestion.  This  is  another  reason  for 
their  interference  with  vegetables,  the  starch  of  which 
is  rather  more  difficult  of  digestion  than  that  of  grains. 

Milk  and  vegetables  are  likely  to  disagree,  for  the 
reason  that  milk,  when  taken  by  itself,  is  retained  in 
the  stomach  but  a  short  time,  its  digestion  being  carried 
on  chiefly  in  the  small  intestine.  Milk  and  meat  are  a 
bad  combination  for  the  same  reason.  Meat  requires 
long  digestion  in  the  stomach,  whereas  milk,  when 
taken  by  itself,  is  quickly  passed  on,  to  be  digested  by 
the  pancreatic  juice.  When  taken  with  meat  or  vege- 
tables, milk,  being  long  retained  in  the  stomach,  under- 
goes fermentation,  resulting  in  sour  stomach,  bilious- 
ness, and  various  other  unpleasant  symptoms. 

If  the  bill  of  fare  taken  at  a  single  meal  were  con- 
fined to  three  or  four  articles  of  food,  there  would  be 
fewer  dyspeptics  scanning  the  newspapers  for  some 
patent  nostrum  to  ' '  aid  digestion. ' ' 

Hot  or  Cold  Bathing  after  Meals. — Especial 
mention  should  be  made  of  the  injury  to  the  digestive 
organs  quite  certain  to  result  from  taking  either  a  hot 
or  a  cold  bath  soon  after  eating.  Few  people  are  aware 
of  the  danger  of  laying  the  foundation  for  years  of  dis- 


MALADIES    OF    THE    STOMACH.  79 

comfort  in  this  way.  If  the  bath  be  a  hot  one,  the  stom- 
ach will  be  deprived  of  the  blood  necessary  to  support 
the  rapid  secretion  of  gastric  juice  for  the  digestion  of 
the  food,  by  its  being  drawn  to  the  surface  of  the  body 
by  the  sudden  relaxation  of  the  capillaries  and  small 
vessels  of  the  skin.  A  cold  bath,  on  the  other  hand, 
or  any  sudden  exposure  to  cold,  may,  by  causing  con- 
traction of  the  blood-vessels  of  the  surface  of  the  body, 
cause  sudden  congestion  of  the  stomach,  which  is 
equally  fatal  to  good  digestion.  Yery  nearly  the  same 
danger  exists  from  bathing  just  before  a  meal. 

The  practice  very  common  among  boys  and  young 
men,  of  going  into  the  water  in  the  summer-time,  re- 
gardless of  the  state  of  the  digestion  or  other  conditions 
of  the  body,  is  a  bad  one.  With  many  it  is  a  very 
usual  practice  two  or  three  times  a  week,  if  not  oftener, 
to  go  into  the  water  immediately  after  the  evening 
meal,  not  even  allowing  time  for  the  work  of  digestion 
to  become  established.  No  bath  involving  any  con- 
siderable portion  of  the  body  should  be  taken  within 
two  hours  after  a  meal,  except  by  the  advice  of  a 
physician. 

Errors  in  Quantity  of  Food. —  If  errors  in  the 
manner  of  taking  food  are  active  causes  of  indigestion, 
mistakes  in  quantity  are  still  more  potent  in  this  direc- 
tion. It  should  be  noted,  however,  that  errors  of  this 
class  are  very  closely  connected  with  others  in  the  man- 
ner of  eating,  and  in  the  quality  of  food  taken.  It  is 
generally  true  with  physical  as  well  as  moral  transgres- 
sion, that  one  bad  habit  invites  another  ;  and  especially 
is  this  the  case  in  reference  to  dietetic  errors.  A  per- 
son who  eats  too  fast  is  likely  to  eat  more  than  is  nee- 


80  THE    STOMACH. 

essary  ;  and  the  same  is  true  if  too  large  a  variety  of 
food  is  partaken  of,  or  food  rendered  exciting  and 
stimulating  by  seasoning  with  irritating  condiments. 

Overeating. —  Intemperance  in  eating  is,  in  the 
opinion  of  the  writer,  responsible  for  a  greater  amount 
of  evil  in  the  world  than  is  intemperance  in  drink.  In- 
deed, it  can  be  clearly  shown  that  intemperate  eating 
is,  in  the  first  place,  one  of  the  most  potent  causes  of 
intemperance  in  drink,  and  also  that  it  is  one  of  the 
obstacles  in  the  way  of  the  reformation  of  those  who 
have  become  the  victims  of  alcoholic  intemperance. 

The  extent  to  which  overeating  is  sometimes  carried 
is  almost  incredible. k  Travelers  in  the  Arctic  regions 
report  that  it  is  not  an  uncommon  thing  for  a  Laplander 
or  an  Eskimo  to  devour  a  large  portion  of  a  small  sheep 
at  a  single  meal.  A  German  authority  reports  the  case 
of  a  hysterical  girl  eighteen  years  of  age,  who  ate  regu- 
larly twelve  times  a  day,  consuming  from  twenty-four 
to  twenty-six  pounds  of  food.  In  another  case  a  woman 
who  was  seized  with  a  peculiar  form  of  morbid  appe- 
tite, known  as  bulimia,  in  forty-five  minutes  ate  twenty- 
three  eggs,  and  drank  three  pints  of  milk  and  two  pints 
of  wine. 

But  if  we  may  believe  the  statements  of  historians, 
gluttony  is  by  no  means  a  modern  vice.  Indeed,  there 
is  quite  good  ground  for  concluding  that  overeating, 
while  a  very  general  fault,  is  rarely,  if  ever,  at  least 
among  civilized  nations,  carried  to  the  enormous  excess 
in  which  some  of  the  luxurious  Roman  emperors  in- 
dulged. 

The  evil  consequences  of  excess  in  eating  are  at  first 
simply  imperfect  digestion,  the  overtaxed  organs  being 


MALADIES    OF    THE    STOMACH.  81 

unable  to  accomplish  the  complete  digestion  of  the 
alimentary  mass.  In  consequence  of  the  delay  which 
occurs,  changes  take  place  by  which  acids  are  developed 
that  irritate  the  mucous  membrane,  together  with 
gases  by  which  the  stomach  is  distended,  and  its  mus- 
cular walls  weakened  and  partially  paralyzed.  In 
course  of  time,  inflammation  of  the  gastric  membrane 
is  developed,  and  permanent  dilatation  of  the  stomach 
occurs. 

This  condition  is  one  which  cannot  usually  be  en- 
tirely cured,  and  which  gives  rise  to  a  great  variety  of 
ailments  in  addition  to  the  discomforts  connected  di- 
rectly with  the  stomach  itself.  These  are  more  fully 
pointed  out  elsewhere.  Dilatation  of  the  stomach  often 
originates  very  early  in  life.  The  writer  has  found  the 
organ  dilated  to  more  than  its  normal  size  in  children 
scarcely  a  dozen  years  of  age,  and  in  many  cases  has 
been  able  to  trace  this  condition  found  in  adults  back 
to  early  childhood. 

An  individual  who  overeats  will  at  first  be  likely 
to  accumulate  flesh  quite  rapidly  ;  but  very  soon  the 
digestion  becomes  so  much  disturbed  that  no  gain  takes 
place,  and,  indeed,  the  patient  not  infrequently  becomes 
considerably  emaciated  even  while  daily  taking  large 
quantities  of  food.  When  the  opposite  is  the  case,  the 
blood  is  filled  with  crude,  imperfectly  elaborated  mate- 
rial, which,  when  absorbed,  fills  the  system  with  poi- 
sonous substances.  At  first  the  liver  is  able  to  exclude 
these  to  a  considerable  extent,  but  after  a  time  the  en- 
ergy of  this  patient  organ  is  entirely  exhausted,  and 
the  whole  system  suffers  in  consequence.  Biliousness 
and  the  various  conditions  usually  attributed  to  torpid- 
6 


82  THE    STOMACH. 

ity  of  the  liver  are  generally  due  to  poisoning  of  tin* 
system  by  toxic  substances  absorbed  from  the  alimen- 
tary canal,  which  may  be  either  the  result  of  the  putre- 
faction of  food  in  a  dilated  stomach  or  colon,  or  the 
products  of  imperfect  digestion. 

Excessive  eating  also  occasions  injury  to  the  health 
by  producing  an  excessive  fulness  of  the  blood-vessels, 
thus  incurring  the  risk  of  rupture  within  the  brain,  and 
resulting  paralysis.  Other  equally  serious  mischiefs 
may  arise  from  the  accumulation  in  the  system  of  a 
greater  quantity  of  nutritive  material  than  can  be  util- 
ized, which  occasions  general  clogging  and  obstruction 
of  all  the  bodily  functions,  and  imposes  an  enormous 
burden  upon  the  kidneys  in  the  elimination  of  the  un- 
usable material. 

Eating  too  Little. —  A  far  less  common  fault 
than  the  one  last  mentioned,  is  eating  too  little.  The 
instances  that  occur  are  usually  in  the  cases  of  those  who 
have  attempted  to  subject  themselves  to  a  rigid  dietetic 
regimen  for  the  prevention  or  cure  of  disease,  and  who, 
from  having  only  a  partial  view  of  the  subject,  enter- 
tain extreme  notions.  By  the  weakening  of  the  system 
which  necessarily  occurs  when  an  insufficient  amount  of 
nutriment  is  received,  the  stomach  also  becomes  wcak 
and  debilitated,  its  secretions  and  muscular  efforts  being 
greatly  impaired  in  both  quantity  and  quality. 

How  Much  Should  a  Person  Eat?  —  Thou- 
sands of  times  has  the  writer  been  asked  this  question, 
The  only  reply  that  can  be  made  to  this  inquiry  is, 
Just  so  much  as  the  system  needs  and  the  digestive 
organs  can  digest.  In  general,  an  individual  may  take 
as  much  food  as  he  can  digest ;  but  often  there  are  com 


MALADIES    OF   THE    STOMACH.  83 

ditions  in  which  he  cannot  digest  as  much  as  he  really 
needs.  For  instance,  when  an  individual  is  called 
upon  to  exert  all  his  energies  of  brain  and  muscle,  to 
strain  every  nerve  to  its  utmost,  to  compass  a  certain 
object  of  great  importance,  to  cope  with  an  emergency, 
he  may  be,  for  the  time  being,  quite  unable  to  digest 
sufficient  food  to  make  good  the  waste  that  must  nec- 
essarily occur.  He  will  lose  flesh  and  strength  under 
such  circumstances  ;  and  often  a  failure  of  the  appetite 
at  such  a  crisis  indicates  the  inability  of  the  stomach  to 
digest,  on  account  of  the  deficient  secretion  of  gastric 
juice.  It  is  in  this  way  that  persons  who  are  for  a  time 
called  upon  to  make  great  exertions  often  break  down 
their  digestion.  Thinking  that  they  need  abundance  of 
nutriment,  which  is  true,  they  eat  as  heartily  as  when 
required  to  perform  only  their  ordinary  work,  not  con- 
sidering their  diminished  power  to  digest  and  appropri- 
ate food,  and  in  a  short  time  find  their  digestive  organs 
unable  to  digest  well  even  a  small  amount  of  food. 
There  is  little  doubt  that  this  is  what  causes  many  law- 
yers, physicians,  and  other  professional  men  to  break 
down.  If,  when  called  upon  to  do  a  large  amount  of 
extra  work,  the  person  would  lessen  the  quantity  of 
food  eaten,  instead  of  increasing  it,  he  would  conserve 
his  vital  forces  much  more  than  by  pursuing  the  oppo- 
site course.  When  required  by  a  press  of  business  to 
do  extra  work,  often  working  for  several  days  in  suc- 
cession with  very  little  sleep,  the  writer  has  been  in  the 
habit  for  many  years  of  limiting  the  amount  of  food 
taken  to  not  more  than  half  the  usual  allowance,  and 
sometimes  to  even  a  less  quantity.  The  result  has  in- 
variably been  all  that  could  be  desired  ;  since,  although 


S4  THE    STOMACH. 

several  pounds  of  flesh  are  often  lost  during  an  ordeal 
of  this  kind,  when  it  is  passed,  and  the  usual  routine  of 
work  is  resumed,  the  digestive  powers  are  intact,  and 
able  to  digest  the  amount  of  food  necessary  for  recu- 
peration, so  that  a  few  days  suffice  to  restore  the  usual 
weight,  and  without  loss  of  either  strength  or  time. 

It  is  evident  that  the  diet  of  each  individual  must 
be  regulated  in  quantity  according  to  his  occupation. 
It  must  also  be  adapted  to  his  age.  A  man  engaged 
in  severe  physical  labor,  while  he  really  requires 
less  food,  may  be  able  to  dispose  of  more  food 
than  one  who  labors  with  equal  intensity  in  some  men- 
tal pursuit.  The  body  is  wasted  much  more  rapidly  by 
vigorous  brain  labor  than  by  physical  exercise  only. 
Indeed,  it  is  asserted  by  our  best  authorities  in  physi- 
ology, that  three  hours  of  severe  brain  labor  are  equal 
in  exhausting  effects  upon  the  system  to  ten  hours  of 
physical  labor  or  muscular  effort.  It  is  evident,  then, 
that  a  man  who  works  his  brain  constantly  for  ten  or 
twelve  hours  a  day  really  needs  more  food  to  sustain 
his  strength  than  a  man  who  employs  his  muscles  for 
the  same  length  of  time. 

But,  as  before  remarked,  the  muscle  laborer  may  be 
able  to  dispose  of  more  food  than  the  brain  laborer, 
though  he  needs  less,  since  his  vital  forces  are  not  so 
completely  exhausted  by  his  work.  In  other  words, 
the  occupation  of  the  muscle  worker  being  less  exhaust- 
ive than  that  of  the  brain  worker,  he  can  overeat  with 
greater  impunity  than  can  the  latter.  Each  should 
eat  only  the  quantity  actually  required,  if  he  would  en- 
joy the  maximum  of  health  and  vigor  ;  but  for  the  man 
whose  vital  energies  are  daily  exhausted  by  mental  ef- 


MALADIES    OF   THE    STOMACH.  OO 

fort,  any  excess  in  eating  is  certain  to  be  most  disastrous. 
We  have  examples  of  great  literary  men  who  have  been 
large  eaters  ;  but  it  is  a  noticeable  fact  that  these  per- 
sons, in  many  instances,  while  celebrated  for  their  pro- 
ductions, often  worked  very  leisurely,  their  fame  being 
really  more  largely  attributable  to  brilliant  genius  than 
to  great  application.  In  several  cases,  too,  as  in  that 
of  Charles  Dickens,  the  hours  spent  in  brain  labor  were 
chosen  from  the  best  of  the  day,  much  time  being 
spent  in  physical  exercise,  by  which  means  the  integrity 
of  the  digestive  organs  was  maintained  to  a  degree 
that  would  otherwise  have  been  impossible.  In  not  a 
few  instances,  too,  those  great  literary  men  who  were 
noted  eaters  died  early,  their  physical  stamina  being 
exhausted  by  the  double  drafts  made  upon  it.  Newton, 
when  engaged  in  the  most  severe  portion  of  his  won- 
derful labors  in  demonstrating  the  law  of  gravitation  by 
computations  respecting  the  orbit  of  the  moon,  confined 
himself  to  a  spare  diet  of  bread  and  water.  The  great- 
est amount  of  food  is  required  by  the  person  who  is 
actively  engaged  in  both  physical  and  mental  labor. 

The  amount  of  food  required  by  an  individual,  as 
already  intimated,  varies  at  different  periods  of  life, 
according  to  the  degree  of  vital  activity.  In  infancy 
and  childhood,  when  the  vital  activities  are  at  their 
highest  degree  of  intensity,  —  when  growth  and  develop- 
ment are  to  be  maintained  in  addition  to  supporting  the 
wastes  of  the  system, — the  demand  for  food  is  greater  in 
proportion  to  the  size  of  the  individual  than  at  any  sub- 
sequent time.  In  adult  life,  when  waste  and  repair  are 
about  equally  balanced,  a  sufficient  amount  is  needed 
to  make  good  the  daily  loss  from  the  various  mental, 


86  THE    STOMACH. 

physical,  and  other  vital  activities  which  can  only  be 
supported  at  the  expense  of  tissue.  Any  larger  quan- 
tity than  this  is  excess. 

In  old  age,  when  the  assimilative  powers  are  weak- 
ened by  declining  years,  the  amount  of  food  which  can 
be  assimilated  by  the  individual  is  even  somewhat  less 
than  what  is  really  needed  ;  hence,  as  age  advances, 
the  quantity  of  food  should  be  gradually  diminished. 
Very  many  old  people  break  down  much  sooner  than 
they  would  otherwise  do,  were  they  more  careful  in 
this  regard.  When  they  lay  aside  their  vigorous,  ac- 
tive life,  they  should  also  curtail  the  quantity  of  their 
food.  By  this  act  of  temperance,  they  might  preserve 
intact  to  a  much  later  period  the  integrity  of  their  di- 
gestive organs,  and  so  add  years  to  their  lives. 

In  not  a  few  instances,  the  foundation  of  dyspepsia 
is  laid  by  some  mechanical  injury,  as  a  sprained  ankle, 
a  broken  limb,  or  a  severe  bruise  or  cut,  which  requires 
rest  from  active  exercise  for  a  few  weeks.  Not  con- 
sidering the  fact  that  much  less  food  is  demanded  when 
a  person  is  not  engaged  in  active  labor  of  any  kind  than 
at  other  times,  the  individual  continues  to  eat  heartily, 
and  soon  finds  his  digestive  organs  refusing  to  do 
their  work  from  sheer  exhaustion.  On  this  account,  it 
should  be  made  a  uniform  custom  to  eat  lightly  on  the 
weekly  rest-day.  The  hearty  Sabbath  dinners  in  which 
many  people  indulge,  making  the  day  an  occasion  of 
feasting  rather  than  a  rest-day,  cannot  be  too  much 
condemned.  The  custom  is  without  doubt  responsible 
for  many  other  forms  of  Sabbath-breaking,  as  no  one 
can  have  clear  perceptions  of  right  and  a  quick  sense 
of  wrong  when  laboring  under  the  incubus  of  an  over- 


MALADIES    OF   THE    STOMACH.  87 

loaded  stomach.  For  the  hearty  meal  usually  taken,  it 
would  be  well  to  substitute  a  light  one,  consisting  mostly 
of  fruits  and  grains. 

This  plan,  if  pursued,  would  do  away  with  much  of 
the  drowsiness  in  church  of  which  many  people  and 
not  a  few  pastors  have  abundant  reason  to  complain. 
The  intellect  would  be  clearer,  and  hence  better  able  to 
appreciate  the  privileges  and  comforts  of  religion.  The 
sooner  people  recognize  the  fact  that  stomachs  have 
much  to  do  with  religion,  and  that  true  religion  includes 
the  government  of  the  appetite,  and  frowns  upon  abuse 
of  the  stomach  as  well  as  abuse  of  a  fellow-man,  the 
better  it  will  be  for  both  stomachs  and  religion. 

Each  individual  must,  to  a  considerable  extent,  be 
his  own  guide  respecting  the  exact  amount  of  food  to 
be  taken  at  a  given  meal.  If  the  appetite  has  been  so 
long  abused  that  it  is  no  longer  a  safe  guide,  then  rea- 
son must  rule.  The  individual  should,  at  the  be- 
ginning of  the  meal,  determine  just  how  much  he  will 
eat ;  and  when  the  specified  quantity  is  taken,  he  must 
resolutely  stop  eating,  leaving  the  table,  if  necessary,  to 
escape  temptation.  The  practice  of  serving  fruit,  pud- 
dings, nuts,  confectionery,  and  tidbits  of  various  kinds 
as  a  dessert,  is  a  pernicious  one.  In  the  first  place,  it 
is  an  inducement  to  overeating,  since  it  is  quite  proba- 
ble that  enough  has  been  eaten  before  the  dessert  is 
served.  If  the  articles  offered  are  wholesome,  they 
should  be  served  and  eaten  with  the  meal,  as  a  part  of 
it,  and  not  at  its  close,  in  addition  to  the  meal.  Fur- 
thermore, it  is  generally  the  case  that  most  of  the  articles 
served  at  dessert  are  wholly  unfit  to  be  eaten  at  any  time, 
and  so  should  be  discarded.  Dessert  is  really  an  in- 


88  THE    STOMACH. 

genious  device  to  lead  people  to  make  dyspeptics  of 
themselves  by  eating  more  than  they  need. 

A  man  who  desires  to  be  at  peace  with  his  stom- 
ach should  learn  to  stop  when  he  has  enough,  no 
matter  how  strongly  he  may  be  tempted  to  do  other- 
wise. There  is  much  more  truth  than  poetry  in  the  old 
Scandinavian  proverb,  "Oxen  know  when  to  go  home 
from  grazing  ;  but  a  fool  never  knows  his  stomach's 
measure."  But  experience,  a  dear  school,  ought  after 
a  time  to  teach  the  most  unobservant  person  the  amount 
of  food  his  stomach  will  bear  without  discomfort  and 
without  injury.  If  a  person  in  fair  health  finds  that 
after  eating  of  wholesome  food  he  is  troubled  with  ful- 
ness- of  the  stomach,  dulness  over  the  eyes  sour 
stomach,  eructations,  or  flatulence,  he  may  be  very  sure 
that  he  is  eating  too  much,  and  he  should  continue  to 
diminish  the  amount  taken  at  each  meal  until  the  symp- 
toms mentioned  disappear. 

It  is  well  to  bear  in  mind  that  the  danger  is  pretty 
much  all  on  the  side  of  overeating,  the  liability  of  eat- 
ing too  little'being  very  small  indeed.  The  tendency 
to  overeat  will  be  greatly  lessened  by  eating  very  slowly, 
masticating  the  food  thoroughly,  and  eating  only  the 
simplest  articles.  One  who  has  never  made  the  experi- 
ment will  be  astonished  to  see  how  little  food  is  really 
required  to  support  life.  The  writer  has  lived  for 
months  at  a  time  on  an  average  of  seventeen  ounces  of 
solid  food  per  day,  gaining  flesh  the  whole  time.  Cor- 
naro,  an  Italian  nobleman,  lived  for  many  years  on 
twelve  ounces  of  solid  food  per  day  ( by  solid  food  is 
meant  the  weight ). 

Numerous   experiments   by  Letheby,    Parkes,    and 


MALADIES    OF   THE    STOMACH.  89 

many  other  scientists,  together  with  a  careful  study  of 
the  dietaries  of  various  classes  of  artisans,  laborers, 
professional  men,  etc.,  show  that  life  can  be  well  sup- 
ported upon  twenty  ounces  of  carbonaceous  and  two 
and  one-half  ounces  of  nitrogenous  food  per  day. 
Pugilists  in  training  usually  take  but  twenty  ounces  of 
solid  food,  and  numerous  classes  of  individuals  subsist 
upon  a  considerably  less  quantity. 

By  reference  to  the  table  of  nutritive  values  given 
on  pages  41,  42,  it  will  be  easily  possible  to  ascertain 
the  amount  of  nutriment  consumed  in  any  given  quan- 
tity of  different  varieties  of  food.  It  is  perhaps  worthy 
of  remark  that  the  grains,  as  shown  in  the  above  table, 
are  by  far  the  most  nutritious  of  all  the  various  classes 
of  food.  It  will  be  observed,  for  instance,  that  oat- 
meal, Indian  meal,  and  peas  contain  three  times  as 
much  real  nutriment  as  lean  beef.  When  economy 
must  be  considered  in  the  selection  of  food,  this  is  a 
very  important  consideration  ;  and  it  becomes  doubly 
evident  when  we  consider  that  it  takes  eleven  pounds 
of  vegetable  food,  including  Indian  meal,  dry  hay,  etc. , 
to  make  one  of  beef.  It  thus  appears  that  a  pound  of 
beefsteak,  or  second-hand  grain,  costs  thirty  times  as 
much  as  a. pound  of  grain  taken  at  first  hand,  besides 
being  vastly  inferior  in  quality. 

Deficiency  in  Necessary  Food  Elements.— 
The  food  may  be  abundant  in  quantity,  and  yet  defi- 
cient in  one  or  more  of  the  various  elements  which 
go  to  make  up  true  food.  If  the  food  is  deficient  in 
farinaceous  and  fatty  elements,  the  individual  will 
soon  show  signs  of  emaciation  in  consequence.  A  lack 
of  the  nitrogenous  elements  will  occasion  still  more 


90  THE    STOMACH. 

marked  effects,  causing  the  stomach  to  lose  its  tone 
and  vigor,  thus  giving  rise  to  acidity,  flatulence,  and 
various  associated  disturbances.  The  deficiency  of  the 
coarser,  innutritious  elements  of  the  food  is  also  very 
soon  felt  by  diminished  activity  of  the  stomach  and 
bowels,  both  in  secretion  and  in  muscular  action. 
Hence  the  great  importance  of  choosing  carefully  and 
judiciously  the  articles -of  food  to  be  taken,  especially 
when  a  regular  dietary  is  to  be  followed.  Such  a  selec- 
tion should  be  made  as  will  supply  to  the  system  all 
the  elements  of  nutrition  in  proper  quantity.  To  em- 
ploy a  dietary  in  which  any  one  of  the  nutritive  ele- 
ments is  deficient,  although  the  quantity  of  the  food 
may  be  all  that  the  digestive  organs  can  digest,  is  as 
really  starvation,  and  will  as  certainly  occasion  the 
same  results  ultimately,  as  total  deprivation  of  food. 
To  attempt  to  live  on  white  bread  and  strong  tea  or 
coffee,  is  as  certain  to  impoverish  the  blood  as  to  refrain 
from  eating  altogether,  the  only  difference  being  in 
the  length  of  time  required  to  bring  about  the  result. 
Thousands  of  pale-faced,  anemic,  thin-blooded,  nerve- 
less, dyspeptic  women  owe  all  their  troubles  to  an  im- 
poverished diet.  Tea  drunkenness  is  not  an  uncommon 
thing  ;  and  in  consequence  of  its  pernicious  influence, 
the  sagacious  physician  not  infrequently  finds  as  well- 
marked  cases  of  scurvy  among  ladies  of  the  higher 
classes  of  society  as  among  the  poorly  fed  sailors  of 
the  whaling  vessel  after  a  long  voyage,  with  prolonged 
confinement  to  a  monotonous  saline  diet.  Young  ladies 
who  attempt  to  exist  with  little  other  food  than  tea, 
pastry,  and'  confectionery,  need  not  wonder  that  they 
grow  to  be  lank,  sallow,  hollow-eyed  dyspeptics.  Un- 


MALADIES    OF    THE    STOMACH.  91 

der  such  a  regimen  the  most  hardy  quadruped  would 
succumb. 

Many  parents  weaken  the  digestive  organs  of  their 
little  ones  for  life  by  feeding  them  when  very  young 
upon  such  insufficient  diet  as  corn-starch  or  arrow-root 
gruel,  and  similar  preparations,  and  when  they  become 
older,  upon  fine-flour  bread.  Repeated  experiments  have 
shown  that  a  dog  will  die  of  starvation  in  a  month  when 
fed  upon  white  or  fine-flour  bread  alone.  Fed  upon 
bread  made  of  the  whole  grain,  or  graham  bread,  dogs, 
as  well  as  other  animals,  suffer  no  deterioration  in 
weight  or  in  strength.  The  difference  between  fine 
flour  and  graham  flour  is  largely  in  the  proportion  of 
gluten  -which  they  contain.  Fine  flour  is  made  from 
the  innermost  portion  of  the  grain,  which  ~is  almost 
pure  starch,  thus  excluding  the  brain-,  nerve-,  and  mus- 
cle-nourishing elements  which  are  found  chiefly  in  the 
portions  of  the  kernel  which  lie  next  to  the  outer  husk. 
"Whole-wheat  flour  also  contains  portions  of  innutritions 
matter  which,  under  most  conditions,  are  advantageous, 
encouraging  both  secretion  and  muscular  activity  of  the 
bowels,  and  thus  preventing  constipation,  which  is  often 
a  forerunner  of  more  serious  disease  of  the  digestive 
organs.  There  are  cases  in  which  the  coarser  portions 
of  the  bran  do  harm  by  causing  irritation  ;  but  these 
do  not  often  occur. 

It  should  be  added  that  the  more  recently  perfected 
processes  employed  in  the  manufacture  of  patent  flour, 
afford  a  product  which  is  both  fine  and  nutritious,  both 
the  innermost  portion  of  the  kernel  and  the  bran  being 
discarded.  But  in  connection  with  this,  there  is  also  a 
grade  of  flour  made,  known  as  "family  flour,"  which 


92  THE    STOMACH. 

consists  only  of  the  central  portion  of  the  grain.  The  re- 
marks respecting  fine  flour  apply  especially  to  this  prod- 
uct, and  not  to  the  best  brands  of  patent  flour.  The 
so-called  "gluten  flours"  which  are  extensively  adver- 
tised, are  for  the  most  part  inferior  to  first-class  whole- 
wheat flour,  and  are  never  in  any  way  superior  to  it. 
Much  that  is  sold  under  the  name  of  graham  flour 
consists  of  inferior  family  flour  mixed  with  coarse 
bran.  Such,  graham  flour  is  not  to  be  recommended. 
The  best  graham  flour  is  tliat  made  by  the  old  milling 
process,  in  which  stones,  instead  of  steel  rollers,  were 
used  for  grinding. 

While  it  is  necessary  to  have  all  the  elements  of 
the  food  in  proper  proportion,  it  is  of  first  importance 
that  the  nitrogenous  elements  be  sufficient  in  quantity, 
even  if  it  should  be  necessary  to  make  use  of  an  ex- 
cess of  farinaceous  foods  to  secure  the  proper  amount, 
since  it  is  of  these  elements  that  the  vital  portions  of 
the  body  are  formed.  The  following  table  shows  the 
respective  amounts  of  different  articles  of  food  required 
to  furnish  the  requisite  quantity  of  nitrogenous  matter 
for  one  day  : — 


Ounces. 

Lean  Meat 15.6 

Eggs 21.2 

Peas 11.2 

Oatmeal 23.0 

Baker's  Bread 36.7 

Wheat  Flour  (fine) 27.5 

Graham  Flour 25.5 

Indian  Meal -]'>.8 

Rye  Meal 37.1 


Pounds. 

Rice 3.0 

Potatoes 8.8 

Carrots 14.2 

Turnips. 1.~».4 

Cabbage 1 5.4 

Parsnips 16.9 

Pints. 

Boer 185 

Milk..  .  4.5 


By  reference  to  the  above  table,  any  one  will  be  able 
so  to  combine  various  articles  of  food  as  to  secure  the 


MALADIES    OF    THE    STOMACH.  93 

proper  amount  of  nitrogenous  matter  without  overload- 
ing the  digestive  organs,  and  yet  give  to  the  food  the 
bulk  necessary  for  good  digestion.  Evidently,  it  would 
overtax  the  stomach  to  digest  turnips  in  sufficient  quan- 
tities to  supply  the  wants  of  the  body,  while  lean  meat 
would  afford  an  insufficient  amount  of  bulk,  as  well 
as  a  deficiency  of  carbonaceous  matter.  By  a  combi- 
nation of  such  nitrogenous  seeds  as  lentils,  peas,  and 
beans,  or  of  oatmeal  or  wheat  meal,  with  potatoes  or 
other  vegetables,  the  difficulty  may  be  overcome,  as 
also  by  combining  eggs  with  the  carbonaceous  grains 
and  vegetables. 

The  proportion  of  carbonaceous  and  nitrogenous 
food  elements  required  for  the  maintenance  of  health  is 
about  one  part  of  the  latter  to  seven  or  eight  of  the 
former.  The  following  table,  including  a  few  of  the 
more  important  articles  of  food,  will  give  a  clear  idea 
of  the  relative  proportion  of  the  two  elements  in  the 
articles  mentioned  : — • 


Lean  Beef. 

Album,  or 

Nitrog. 

1 

Carbon- 
aceous. 

.5 

Wheat  Meal 

Album,  or 
Nitrog. 

or 

Carbon- 
aceous. 

Sea's.  .  , 

1 

1.9 

Bread.  .  .  . 

1 

7.0 

Peas  

1 

2.7 

Rye  Meal.  . 

1 

9.8 

Milk       .    . 

.    ..    1 

3.6 

Potatoes  .  .  . 

.    .          1 

10.7 

Fat  Beef  .  .  . 

1 

5.0 

Carrots  .... 

] 

11.5 

Oatmeal  .  .  . 

1 

(i.l 

Barley  Meal 

1 

12.7 

IndianMeal 

.    I 

7.7 

Rice.  . 

.   1 

13.0 

According  to  M.  Germain  See,  of  Paris,  one  of 
the  most  eminent  French  physicians,  observations  upon 
different  races  and  physiological  experiments  show  that 
the  amount  of  albumen  heretofore  supposed  necessary 
for  the  maintenance  of  health  is  greater  than  is  actually 
required,  and  that  the  proportion  of  this  element  need 
not  exceed  one  ninth  to  one  tenth.  About  the  same 


94  THE    STOMACH. 

amount  of  fat  is  required,  the  balance  to  be  starch 
or  sugar..  According  to  this  authority,  twenty  to 
twenty-one  ounces  of  water-free  food  is  required  for  a 
daily  ration,  of  which  two  to  two  and  one-third 
ounces  should  be  albumen  or  its  equivalent,  two  ounces 
of  fat,  and  the  remainder  starch  and  sugar.  As  we 
have  elsewhere  shown,  starch  is  much  to  be  preferred 
to  sugar  as  a  form  of  carbonaceous  food.  This  re- 
mark, of  course,  applies  especially  to  cane-sugar, 
since  the  sugar  of  fruits  is  already  advanced  in  the 
digestive  process,  whereas  cane-sugar  hinders  diges- 
tion, and  produces  gastric  catarrh. 

The  Quality  of  Food. — Man,  like  other  animal-, 
is  made  of  what  he  eats,  and  we  may  well  'credit  the 
assertion  of  an  eminent  author,  that  the  general  ten- 
dency of  thought  in  any  nation  may  be  determined  by 
the  character  of  the  national  diet.  True  as  this  princi- 
ple is  when  applied  to  the  body  in  general,  it  is  espe- 
cially true  in  reference  to  the  stomach.  JSTo  organ  is 
so  directly  and  so  profoundly  affected  by  the  quality  of 
the  food  as  is  the  stomach.  Hence  we  may  well  con- 
sider with  care  the  various  ways  in  which  the  digestive 
organs  may  become  impaired  through  defects  in  the 
quality  of  the  food. 

Bad  Cookery. — As  a  potent  cause  of  dyspepsia, 
bad  cookery  deserves  first  mention  in  this  connection. 
The  real  object  of  cooking  is  to  render  the  elements  of 
food  more  digestible.  It  is  intended,  indeed,  to  be  a 
sort  of  partial  preliminary  digestion  of  the  food  ;  but 
the  numerous  devices  of  cooks  and  caterers,  with  their 
complex  and  indigestible  mixtures,  have  so  far  sub- 
verted the  original  design  of  the  process  as  to  render 


MALADIES    OF    THE    STOMACH.  95 

cooking  a  means  of  making  food  indigestible  as  often 
as  otherwise.  Altogether  too  little  attention  is  paid  to 
the  subject  of  cookery  as  a  science.  In  the  majority 
of  cases  the  task  of  preparing  food  for  the  palate  (the 
stomach  is  seldom  thought  of )  is  intrusted  to  ignorant 
servant-girls  or  colored  cooks,  who  compound  their  mix- 
tures by  ' '  the  rule  of  thumb, ' '  and  without  any  ref- 
erence whatever  to  the  physiological  wants  of  the  body. 
Some  slight  indications  of  reform  in  this  direction  are 
shown  in  the  establishment  of  schools  of  cookery  in 
the  larger  cities,  and  lectureships  on  the  subject  in  some 
of  our  female  seminaries.  To  become  a  good  cook  re- 
quires as  much  native  ability  and  far  more  practical 
experience  than  to  become  a  musician  or  a  school- 
teacher, or  even  to  enter  some  of  the  learned  profes- 
sions. The  position  of  cook  ought  to  be  made  so  re- 
spectable and  lucrative  that  it  will  attract  persons  of 
sufficient  mental  capacity  and  culture  to  make  the  art 
subservient  to  the  purposes  for  which  it  was  first  em- 
ployed and  designed.  A  bad  cook  in  a  family  is  a 
worse  enemy  to  the  health,  the  comfort,  and  even  the 
morals  of  the  household,  than  would  be  a  swamp  gen- 
erating malaria  a  half-mile  away,  a  cesspool  fever-nest 
at  the  back  door,  smallpox  across  the  street,  or  a  Chi- 
nese joss-house  in  the  next  block.  Give  us  good 
cooks, —  intelligent  cooks,  cooks  who  are  thoroughly 
educated, —  and  the  cure  of  nine  tenths  of  all  the 
dyspeptics  may  be  guaranteed,  without  money  and  with- 
out medical  advice. 

Fried  Food. —  Of  all  dietetic  abominations  for 
which  bad  cookery  is  responsible,  fried  dishes  are  the 
most  pernicious,  Meats,  fried,  fricasseed,  or  other- 


96  THE    STOMACH. 

wise  cooked  in  fat,  fried  bread,  fried  vegetables,  dough- 
nuts, griddie-cakes,  and  all  other  similar  combinations 
of  melted  fat  with  other  elements  of  food,  are  most 
difficult  articles  of  digestion.  None  but  the  most 
stalwart  stomach  can  master  such  indigestibles.  The 
gastric  juice  has  little  more  action  upon  fats  than  has 
water.  Hence  a  portion  of  meat  or  other  food  satur- 
ated with  fat  is  as  completely  protected  from  the  action 
of  the  gastric  juice  as  is  a  foot  within  a  well-oiled  boot 
from  the  snow  and  water  outside.  It  is  marvelous  in- 
deed that  any  stomach,  under  any  circumstances,  can 
digest  such  food,  and  it  is  far  from  remarkable  that 
many  stomachs  after  a  time  rebel. 

It  is  principally  for  this  same  reason  that  rich 
cake,  shortened  pie-crust,  and  pastry  in  general,  as 
well  as  warm  bread  and  butter,  so  notoriously  disagree 
with  weak  stomachs,  and  are  the  efficient  cause  in  pro- 
ducing disease  of  the  digestive  organs.  The  digestion 
of  the  food  being  interfered  with  by  its  covering  of  fat, 
fermentation  takes  place.  The  changes  occasioned  in 
the  fat  develop  in  the  stomach  extremely  irritating  and 
injurious  acids,  which  irritate  the  mucous  membrane  of 
the  stomach,  causing  congestion,  and  sometimes  chronic 
inflammation. 

Uncooked  Food. — Raw  foods  and  food  which 
has  been  insufficiently  cooked,  are  a  frequent  cause  of 
indigestion.  This  is  especially  true  of  uncooked  vege- 
tables. Man  is  naturally  a  frugivorous  animal,  and  is 
able  to  make  use  of  vegetables  and  many  grains  as  food 
only  by  the  aid  of  cookery. 

As  will  be  recalled,  the  digestion  of  starch  is  effected 
by  both  the  saliva  and  the  pancreatic  juice.  Salivary 


MALADIES    OF   THE    STOMACH.  97 

d:gestion  takes  place  in  the  mouth  and  the  stomach, — 
chiefly  in  the  stomach,  of  course,  as  the  food  is  not 
retained  in  the  mouth  for  a  sufficient  length  of  time  to 
allow  the  digestive  process  to  proceed  beyond  the  pre- 
liminary stage.  In  the  digestion  of  starch,  the  starch 
is  first  rendered  soluble,  and  is  then  converted  into 
dextrin,  and  finally  into  malt-sugar,  or  maltose.  The 
digestive  principle  of  the  saliva  is  incapable  of  acting 
upon  raw  starch,  but  the  pancreatic  juice  digests  raw 
starch,  although  with  less  facility  than  cooked  starch. 

By  the  action  of  heat  the  starch  granules,  which 
consist  of  the  starch  proper  enclosed  in  little  capsules, 
are  ruptured,  and  thus  the  digestive  juices  can  readily 
come  in  contact  with  and  digest  the  starch. 

By  the  prolonged  action  of  moderate  heat,  or  by 
exposure  to  a  high  temperature  for  a  shorter  time, 
starch  is  converted  into  dextrin.  Similar  changes 
take  place  in  ripening  fruit.  Green  fruit  contains  a 
large  amount  of  starch  ;  in  the  process  of  ripening,  this 
starch  is  converted  into  dextrin  and  sugar,  as  in  the 
process  of  digestion,  so  that  in  the  use  of  fruit  the  starch 
is  taken  in  a  partially  or  completely  digested  state, 
which  accounts  for  the  easy  digestibility  of  this  kind 
of  food. 

When  starchy  substances  are  eaten  raw,  the  saliva 
being  unable  to  act  upon  the  uncooked  starch,  the 
gastric  juice  cannot  gain  access  to  the  albuminous  sub- 
stances present,  and  hence  these  particles  are  not 
broken  up,  and  being  retained  in  the  stomach  for  too 
long  a  time,  fermentation  and  irritation  are  the  result. 
It  is  for  this  reason  that  green  fruit  and  raw  vegetables 
occasion  so  much  disturbance  of  the  stomach  and 
7 


98  THE    STOMACH. 

bowels,  these  immature  foods  containing  large  quanti- 
ties of  starch  in-  a  very  indigestible  state.  By  cooking, 
unripe  fruit  and  vegetables  may  be  in  a  great  degree 
deprived  of  their  injurious  properties.  Cooking  is  thus 
a  sort  of  preliminary  digestion. 

In  Scotland,  the  eating  of  oatmeal  imperfectly 
cooked  is  a  very  common  practice,  the  result  of  which 
is  almost  universal  suifering  from  a  peculiar  form 
of  indigestion  due  to  it,  known  as  water-brash.  The 
Scotch  farmer  prefers  his  oatmeal  raw  because  of  its 
indigestibility,  as  the  result  of  which  it  "stays  by  the 
stomach"  longer  than  when  well  cooked.  Nearly  all 
kinds  of  food  are  much  more  easy  of  digestion  after 
cooking  than  before,  providing  the  cooking  is  per- 
formed in  the  proper  manner.  For  vegetables  and 
grains,  cooking  is  especially  necessary. 

Decayed  Food. —  Much  harm  comes  from  eating 
food  which  has  made  appreciable  advancement  in  the 
direction  of  decay.  This  is  true  both  of  vegetable  and 
animal  food.  By  the  process  of  decomposition,  poison- 
ous elements  are  developed  in  animal  and  vegetable 
substances,  especially  the  former,  which  do  not  nat- 
urally exist  there.  If  decomposition  is  far  advanced, 
these  poisons  may  exist  in  such  quantity  as  to  produce 
immediate  ill  effects,  sometimes  occasioning  death  in  a 
few  hours.  Instances  of  this  kind  have  often  occurred 
from  eating  canned  meats  which  had  spoiled,  or  which 
had  been  kept  for  a  short  time  after  opening.  The 
practice  in  vogue  in  some  other  countries,  and  to  a  cer- 
tain extent  in  this,  of  keeping  meat  for  some  days 
before  eating,  so  as  to  give  it  tenderness  and  a  ' '  high  ' ' 
flavor,  is  a  most  pernicious  one.  Better  far,  for  health, 


MALADIES    OF   THE    STOMACH.  99 

is  the  barbarous  Abyssinian  custom  of  eating  the  flesh 
raw  and  while  still  warm  arid  quivering. 

For  dyspeptics  such  food  is  especially  bad,  since 
digestion  is  so  slow  that  decomposition  is  not  corrected, 
as  it  is  to  some  extent  in  a  healthy  stomach,  by  the, 
gastric  juice,  but  is  allowed  to  continue,  with  all  its 
serious  consequences  Even  if  no  immediate  effects 
follow  the  use  of  such  food,  the  poisons  generated 
may  be  absorbed,  and  appear  later  in  some  form  of 
blood-poisoning.  The  stomach  of  a  hyena  may  be  able 
to  digest  the  putrid  flesh  of  a  decaying  carcass  ;  but 
man's  stomach  was  not  intended  for  scavenger  use,  and 
requires  fresh,  untainted  food. 

Shell-fish,  and,  in  fact,  fish  of  all  kinds,  are  par- 
ticularly prone  to  decomposition,  undergoing  this  change 
much  more  quickly  than  do  other  forms  of  animal 
food.  It  is  partly  for  this  reason  that  poisoning  from 
the  use  of  oysters  and  fish  occurs  so  frequently,  and 
sometimes  with  fatal  results.  Experiments  recently  con- 
ducted by  Trombetta,  an  eminent  French  physiolo- 
gist, show  that  decomposition  of  flesh  begins  within 
twenty-four  to  forty-eight  hours  after  the  death  of  the 
animal,  even  when  the  flesh  is  kept  within  a  refrigera- 
tor. Germs  rapidly  increase  after  the  death  of  the  ani- 
mal, and  even  after  so  short  a  period  are  found  in 
abundance.  It  thus  appears  that  all  flesh  food  must  con- 
tain more  or  less  of  poisonous  matters,  the  products  of 
decomposition.  Bouchard  has  shown  that  meat  juice 
is  very  deadly  in  its  effects  when  injected  into  the  veins 
of  an  animal,  in  consequence  of  the  poisons  which  it 
contains.  Beef  tea  is,  for  the  most  part,  made  up  of 
soluble  substances  contained  in  the  flesh  of  the  animal  at 


THE    STOMACH. 

death,  or  developed  by  the  action  of  germs  after  death. 
An  eminent  French  physician,  speaking  of  beef  tea. 
remarked  that  "it  is  a  true  solution  of  ptomains " 
(poisons). 

Cheese  is  another  article  which  contains  poisonous 
substances  known  as  ptomains,  in  great  quantities,  and 
not  only  poisons,  but  germs  capable  of  producing  poi- 
sons in  abundance  in  the  stomach.  Cases  of  cheese 
poisoning  are  a  frequent  and  sometimes  fatal  result  of 
the  use  of  cheese.  Cholera  morbus,  a  disease  due  to 
germs,  is  frequently  induced  by  eating  cheese.  That 
poisoning  does  not  always  occur  from  the  use  of  cheese 
is  due  to  the  fact  that  the  gastric  juice  of  a  healthy 
stomach  is  capable  of  destroying  a  considerable  quantity 
of  germs,  and  that  the  liver  is  capable  of  destroying 
the  poisons  introduced  with  the  cheese  in  considerable 
amount.  Milk  sometimes  gives  rise  to  indigestion  and 
serious  illness  in  consequence  of  the  disease-producing 
microbes  which  it  contains. 

Soft  Food. —  The  structure  of  man's  teeth  indi- 
cates that  he  was  intended  to  employ  a  diet  consisting 
of  food  of  such  consistency  as  to  require  vigorous 
mastication.  His  jaws  are  armed  with  thirty-two 
strong  teeth,  compactly  arranged  in  the  mouth  in  such 
a  manner  as  to  make  them  most  available  for  use. 
Obeying  the  general  law  governing  all  organized  struc- 
tures, by  which  organs  develop  or  degenerate  according 
as  they  are  used  or  allowed  to  remain  inactive,  the 
teeth  retain  their  health  if  vigorously  employed  in  the 
mastication  of  solid  food,  but  rapidly  undergo  decay 
when  not  thus  used.  We  have  an  illustration  of  this 
in  cows  fed  on  distillery  slops.  The  teeth  of  such 


MALADIES    OF   THE    STOMACH. 


101 


animals  decay  and  drop  out  for  want  of  use,  while  those 
of  cattle  which  keep  their  teeth  actively  employed  in 
chewing  the.  cud,  are  preserved  intact. 

The  effect  of  soft  food  upon  the  teeth  of  an  animal 
is    well    shown    in    the    accompanying    illustrations. 


FIG.  14.—  TEETH  OF  HEALTHY  Cow. 

Fig.  14  represents  the  teeth  of  a  cow  fed  upon  proper 
food.  Fig.  15  shows  the  teeth  of  a  cow  fed  upon  dis- 
tillery slops. 

The  same  is  true  of  human  beings.  Eating  soups, 
gruels,  and  other  soft  foods,  to  the  exclusion  of  articles 
requiring  mastication,  ruins  the  teeth  at  the  same  time 
that  it  disorders  the  stomach  through  the  taking  of  too 
much  fluid,  thus  causing  deficient  insalivation. 

Too  Abundant  Use  of  Fats. —  Unfortunately 
for  the  poor  stomach,  the  opinion  prevails  almost 
everywhere  that  food  made  rich  with  fat  ip  the  most 
nourishing.  Undoubtedly  fat  is  an  element  of  nutri- 
tion, and  can  be  digested  and  assimilated  when  taken 
in  proper  quantities  and  in  a  proper  manner ;  but  the 
excessive  use  of  fats  of  various  kinds,  as  lard,  suet, 
butter,  and  other  animal  and  vegetable  fats  or  oils,  is  a 


COL'    ;  c 
l-KI  £ 

. 


102 


THE    STOMACH. 


prolific  cause  of  certain  forms  of  indigestion,  especially 
that  known  as  bilious  dyspepsia.  The  famous  physiol- 
ogist Bernard  many  years  ago  determined  by  careful 
experiment  the  fact  that  the  free  use  of  fats  greatly 
reduces  the  biliary  secretion,  the  quantity  of  bile  be- 
ing diminished  in  some  instances  to  a  very  small  fraction 
of  the  amount  secreted  when  only  pure  water  or  food 
containing  little  fat  was  taken.  When  it  is  remembered 
that  the  bile  is  an  essential  element  for  the  digestion  of 
fat,  it  will  be  seen  that  a  diminution  of  this  digestive 
fluid  in  connection  with  the  taking  of  an  extra  quantity 
of  oleaginous  matter  is  a  most  unfortunate  circum- 
stance, since  it  is  thus  absent  when  most  needed.  This 
fact  sufficiently  well  accounts  for  the  distressing  symp- 
toms which  accompany  the  excessive  use  of  fats  by 
those  whose  digestion  has  been  already  weakened  by 


FIG.  15.—  TEETH  OF  Cow  FED  ON  DISTILLERY  SLOPS. 

abuse  of  this  kind.  The  diminished  quantity  of  bile 
produced  by  the  liver  is  also  sufficient  cause  for  the 
condition  established  by  the  over-use  of  fats,  vulgarly 
known  by  the  expressive  term  "bilious."  The  ele- 
ments which  ought  to  be  eliminated  from  the  system 


. 


MALADIES    OF   THE    STOMACH.  103 

are  retained,  clogging  the  vital  machinery,  and  giving 
rise  to  many  symptoms  of  systemic  poisoning. 

When  it  is  remembered  that  the  bile  is  the  antisep- 
tic agent  by  which  the  contents  of  the  small  intestines 
are  preserved  from  decomposition,  it  will  readily  be 
seen  that  a  deficiency  of  bile  must  result  in  decompo- 
sition of  food  elements,  and  the  formation  of  poisonous 
substances.  The  absorption  of  these  substances  still 
further  disturbs  the  liver,  contaminates  the  body,  and 
produces  the  condition  of  general  poisoning  which 
is  commonly  termed  biliousness  or  bilious  dyspepsia,  a 
state  which  is  not  to  be  remedied  by  the  use  of  liver 
medicines,  purgatives,  etc.,  but  by  correction  of  the 
diet. 

Fats  readily  undergo  decomposition  in  the  stomach, 
especially  in  a  stomach  which  is  dilated  so  that  the  food 
is  too  long  retained,  or  in  one  which  is  the  seat  of  gas- 
tric catarrh.  It  is  on  this  account  that  fats,  even  in 
the  form  of  butter  or  mingled  'with  the  food,  as  in 
rich  gravies  or  the  shortening  in  pie-crust,  are  so  often 
a  source  of  irritation  and  disturbance  in  dyspeptic* 
stomachs. 

The  use  of  rich  foods  is  not  infrequently  a  cause 
of  bilious  headache  or  a  bilious  attack.  Animal  fats 
are  more  likely  to  undergo  this  decomposition  than  are 
vegetable  fats.  Ordinary  butter  is  particularly  un- 
wholesome, for  the  reason  that  it  always  contains  mul- 
titudes of  microbes  derived  from  the  milk,  which  are 
rapidly  developed  in  the  stomach,  producing  decom- 
position of  the  fat,  and  thus  forming  irritating  fatty 
acids.  Only  sterilized  butter  is  fit  for  human  con- 
sumption. 


104  THE    STOMACH. 

Cooked  fats  are  also  much  more  irritating  and  likely 
to  produce  indigestion  than  uncooked  fats.  The  process 
of  cooking  develops  acrid  fatty  acids  which  are  ex- 
tremely irritating  to  the  gastric  mucous  membrane. 
This  is  one  of  the  reasons  why  fried  and  fricasseed  foods, 
griddle-cakes,  doughnuts,  Saratoga  chips,  etc.,  are  so 
harmful  to  digestion.  Fats  taken  in  the  form  of  cream 
are  generally  more  digestible  than  in  any  other  way. 
In  some  cases,  however,  there  is  an  inability  to  digest 
the  casein  of  milk  in  the  form  of  cream  ;  for  such  cases 
sterilized  butter  is  to  be  preferred.  The  least  harmful 
mode  of  using  a  free  fat  is  in  the  form  of  sterilized  but- 
ter taken  with  cold  bread.  Melted  fat  taken  with  fari- 
naceous substances  is  extremely  hurtful,  as  the  starchy 
particles  are  so  completely  surrounded  and  permeated 
by  the  fat  that  the  saliva,  which  should  act  upon  the 
starch  in  the  stomach,  is  unable  to  do  so,  thus  leading 
to  indigestion. 

The  use  of  natural  foods  containing  a  sufficient 
quantity  of  fat  is  much  to  be  preferred  to  the  use  of 
•free  fat.  In  cream  the  fat  is  in  a  finely  divided  state 
in  which  it  can  mingle  readily  with  the  fluids  of  the 
stomach  ;  hence  it  does  not  smear  over  those  food  sub- 
stances which  are  acted  upon  by  the  gastric  juice  and 
the  saliva,  thus  preventing  their  digestion.  Neither 
the  gastric  juice  nor  the  saliva  has  any  action  upon  fat, 
and  for  this  reason  free  fats  may  constitute  a  very 
serious  obstacle  to  the  action  of  both  the  saliva  and  the 
gastric  juice. 

Nuts  also  afford  a  most  excellent  form  of  fat.  The 
popular  idea  that  nuts  are  difficult  of  digestion  is  the 
natural  outgrowth  of  the  common  habit  of  swallowing 


MALADIES    OF   THE    STOMACH.  105 

them  without  mastication.  Nuts  have  a  firm,  hard 
structure,  requiring  very  thorough  mastication.  If 
pains  is  taken  to  chew  them  very  thoroughly,  nuts  are 
as  digestible  and  wholesome  as  any  other  food,  and 
they  are  highly  nutritious.  Lack  of  sound  teeth  is,  in 
some  cases,  an  almost  insuperable  obstacle  to  the 
proper  mastication  of  nuts,  as  well  as  of  other  hard  foods. 
The  writer  has  succeeded  in  meeting  this  difficulty — in 
the  case  of  nuts,  at  least — by  preparing  from  some  of 
the  best  and  most  nutritious  nuts  a  very  fine  and  thor- 
oughly cooked  meal,  and  also  a  nut  cream  or  butter. 
The  latter,  like  cream,  is  nearly  a  perfect  emulsion,  but 
is,  at  the  same  time,  so  rich  in  fat  as  to  be  an  excellent 
substitute  for  butter.  It  is  especially  useful  in  season- 
ing foods,  and  serves  a  most  excellent  purpose  as  a 
dressing  for  vegetables  and  other  foods  which  are 
deficient  in  fats.  These  nut  preparations  are  manufact- 
ured and  sold  by  the  Sanitas  Food  Co.,  Battle  Creek, 
Mich.  (  See  page  241.) 

The  Use  of  Sugar  in  Excess. —  While  sugar, 
like  fat,  is  a  true  alimentary  principle,  capable  of  aid- 
ing in  the  maintenance  of  life  when  employed  with 
the  other  elements  of  food,  if  used  in  excess,  it  becomes 
a  serious  source  of  disease.  When  used  alone,  it  is 
utterly  incapable  of  supporting  the  vital  activities  of 
the  body,  being,  in  this  respect,  analogous  to  starch, 
its  food  equivalent.  The  popular  idea  that  sugar  nour- 
ishes the  nerves  or  the  brain,  makes  the  teeth  sound, 
and  is  both  harmless  and  wholesome,  is  quite  a  mistake, 
as  many  an  innocent  little  one  whose  fond  parents 
shared  in  the  general  error,  has  found  out  to  the  regret 
and  sorrow  of  his  friends. 


106  THE    STOMACH. 

The  different  forms  of  sugar,  molasses,  sirup,  trea- 
cle, honey,  etc. ,  are  essentially  the  same  in  their  effects, 
except  that  molasses  and  honey  sometimes  contain  pecul- 
iar elements  that  to  some  persons  seem  to  be  almost 
active  poisons.  This  is  especially  true  of  honey. 

The  injury  from  the  use  of  sugar  or  other  saccharine 
substances  is  occasioned,  first,  by  the  readiness  with 
which  it  undergoes  fermentation  when  subjected  to 
warmth  and  moisture.  In  the  stomach  it  finds  all  the 
conditions  necessary  for  inducing  fermentation  ;  and 
were  it  not  that  saccharine  substances  in  solution  are 
usually  so  quickly  absorbed  that  it  is  difficult  for  the 
chemist  even  to  detect  their  presence  in  the  stomach, 
this  change  would  always  occur.  When  a  larger  quan- 
tity is  taken  than  can  be  absorbed  promptly,  or  when 
taken  in  such  form  as  to  make  ready  absorption  impos- 
sible, as  in  the  case  of  preserves  and  sweetmeats  of 
various  sorts,  acid  fermentation  does  ,  occur,  and  with 
serious  results  not  only  to  the  stomach,  but  to  the  whole 
system.  The  fermentation  set  up  not  only  develops 
acids  and  gases  from  the  sugar,  but,  being  communi- 
cated to  the  other  elements  of  the  food,  as  the  starch 
and  especially  the  fatty  elements,  still  worse  forms  of 
fermentation  or  decomposition  occur ;  and  the  food  is 
thus  rendered  unfit  to  nourish  the  body,  while  the  mu- 
cous membrane  of  the  stomach  and  intestines  is  irritated 
by  the  contact  of  unnatural  corroding  elements  in  the 
food,  and  through  their  absorption,  the  whole  system 
becomes  affected. 

The  excessive  use  of  sugar  also  greatly  overtaxes 
the  liver,  which  has  an  important  part  to  act  in  its 
digestion,  interfering  with  the  proper  performance  of 


MALADIES    OF    THE    STOMACH.  107 

its  other  functions,  eopecially  those  of  bile-making  and 
poison-destroying,  and  thus  leaving  the  elements  which 
it  ought  to  eliminate,  to  accumulate  in  the  system. 
Thus  a  person  may  become  ' '  bilious ' '  from  the  over- 
use of  sugar  as  well  as  from  the  excessive  use  of  fats. 

When  taken  into  the  stomach  in  considerable  quan- 
tities, sugar  gives  rise  to  a  profuse  flow  of  mucus,  and 
may  thus  eventually  develop  chronic  catarrh  of  the 
stomach,  which,  extending  into  the  duodenum  and 
the  bile  ducts,  produces  catarrhal  jaundice  and  the 
partial  closure  of  the  biliary  passages.  When  sugar  is 
used  to  excess  for  a  considerable  length  of  time,  the 
liver  finally  loses  its  ability  to  retain  the  sugar  in  its 
tissues  in  the  form  of  glycogen, —  one  of  its  most  impor- 
tant functions, —  so  that  an  excessive  quantity  of  sugar 
is  thrown  into  the  blood,  and,  being  eliminated  by  the 
kidneys,  appears  in  the  urine.  This  is  tli3  most  fre- 
quent and  most  common  origin  of  diabetes.  The  writer 
has  met  cases  in  which  nearly  a  pound  of  sugar  was 
thus  eliminated  through  the  kidneys  in  twenty-four 
hours,  and  quite  a  number  of  cases  in  which  more  than 
half  a  pound  of  sugar  was  thus  thrown  out  of  the  body 
in  the  same  length  of  time.  Sugar  is  never  found  in 
the  urine  in  a  state  of  health. 

Excessive  use  of  sugar  is  also  a  most  common  cause 
of  obesity.  The  excess  of  carbonaceous  material  in  the 
form  of  sugar  being  deposited  as  fat,  or  adipose  tissue, 
overwhelms  the  heart  so  that  this  excess  of  fat  is  some- 
times attended  by  fatal,  results. 

Excessive  Use  of  Flesh  Food. —  The  flesh  of 
animals,  especially  lean  meat,  is  usually  considered  the 
most  easily  digested  and  strengthening  of  all  foods. 


108  THE    STOMACH. 

This  fact,  together  with  the  stimulating  character  of 
this  class  of  foods,  is,  perhaps,  the  cause  of  its  extensive 
use  in  English-speaking  countries,  especially  in  Eng- 
land and  America.  The  fact  that  immediate  distress 
and  unpleasant  symptoms  relating  to  the  stomach  itself 
less  frequently  follow  the  use  of  flesh  food  than  the  use 
of  many  other  foods,  is  perhaps  one  cause  for  this  mis- 
apprehension. While  it  is  true  that  meat,  especially 
lean  meat,  is  more  readily  digested  in  the  stomach 
than  coarse  vegetables,  and  is  less  likely  to  ferment, 
forming  gas  and  irritating  acids  in  the  stomach,  than 
are  saccharine  and  starch  foods,  it  is  nevertheless  true 
that  meats  are,  of  all  foods;  most  exciting  and  stimu- 
lating to  the  stomach ;  and  when  freely  used,  the 
ultimate  result  is  to  produce  a  condition  of  debility  in 
the  stomach,  and  in  some  cases  gastric  catarrh  and 
other  stomach  disorders  may  be  attributed  to  the  exces- 
sive use  of  meat.  The  worst  effects,  however,  from  an 
excessive  use  of  meat  are  to  be  sought  in  the  liver  and 
in  the  body  in  general,  resulting  in  rheumatism,  gout, 
neurasthenia,  and  a  great  variety  of  diseases  which  have 
their  origin  in  the  introduction  of  an  excessive  quantity 
of  toxic  substances  into  the  body  through  the  use  of 
meat. 

The  practice  now  much  in  vogue,  of  administering 
large  quantities  of  raw  or  under-done  meat,  either  in  the 
form  of  an  ordinary  steak  or  chop,  or  specially  prepared, 
as  by  scraping  or  mincing,  has  been  productive  of  a  vast 
deal  of  injury.  The  writer  has  noted  several  instances 
of  acute  Bright' s  disease  in  which  general  symptoms 
of  poisoning  and  various  nervous  maladies  could  be  di- 
rectly attributed  to  following,  for  a  number  of  months, 


MALADIES    OF   THE     STOMACH.  109 

a  prescription  requiring  raw  meat  as  a  principal  article 
of  diet. 

Condiments. —  By  condiments  are  meant  all  sub- 
stances added  to  food  for  the  mere  purpose  of  render- 
ing it  more  palatable,  but  possessing  no  positive  nutri- 
tive value  in  themselves.  Mustard,  vuaegar,  pepper, 
cinnamon,  and  various  other  spices  are  included  in 
this  category,  together  with  salt,  although  the  last- 
named  article  is  by  some  held  to  be  of  the  nature  of  a 
food,  and  supposed  to  supply  some  want  in  the  body. 

Mustard,  pepper,  pepper-sauce,  cinnamon,  cloves, 
cardamoms,  and  similar  substances  are  of  an  irritating, 
stimulating  character,  and  work  a  two-fold  injury  upon 
the  stomach.  By  contact,  they  irritate  the  mucous 
membrane,  causing  congestion  and  diminished  secretion 
of  gastric  juice,  when  taken  in  any  but  very  small  quan- 
tities. This  fact  was  demonstrated  by  the  observations 
of  Dr.  Beaumont  upon  St.  Martin.  After  several  years' 
careful  study  of  the  relations  of  various  foods,  drinks, 
etc.,  to  the  stomach,  Dr.  Beaumont  stated,  in  summing 
up  his  experiments,  that  ' '  stimulating  condiments  are 
injurious  to  the  healthy  stomach."  He  often  saw  con- 
gestion produced  in  the  mucous  membrane  of  St.  Mar- 
tin's stomach  by  his  eating  food  containing  mustard, 
pepper,  and  similar  condiments. 

When  taken  in  quantities  so  small  as  to  occasion  no 
considerable  irritation  of  the  mucous  membrane,  condi- 
ments may  still  work  injury  by  their  stimulating  effects, 
when  long  continued.  The  stomach  being  at  first  ex- 
cited to  more  than  natural  activity,  afterward  suffers 
from  reaction,  and  is  left  in  #n  inert,  diseased  state, 
incapable  of  secreting  sufficient  gastric  juice  to  supply 


110  THE    STOMACH. 

the  needs  of  the  system  in  digesting  food.  This  final 
result  is  often  averted  for  some  time  by  increasing  tha 
quantity  of  the  artificial  stimulus  ;  but  nature  gives 
way  at  last,  and  chronic  disease  is  the  result. 

In  experiments  conducted  in  the  Laboratory  of 
Hygiene  connected  with  the  Battle  Creek  (Michigan, 
U.  S.  A.)  Sanitarium,  we  have  found  that  the  use  of 
condiments  does  not  increase  the  flow  of  either  saliva 
or  gastric  juice,  but  causes  an  outpouring  of  a  great 
quantity  of  protective  mucus.  When  this  becomes  ha- 
bitual, the  individual  is  the  subject  of  gastric  catarrh, 
a  disorder  which  is  by  no  means  easily  cured.  The 
writer  quite  agrees  with  the  conclusions  of  the  small 
boy  who,  having  tasted  horseradish  for  the  first  time, 
spat  it  out,  remarking  to  his  mother,  "  Mamma,  I  think 
I  won't  eat  that  till  it  gets  cold."  Substances  which 
are  hot  when  they  are  cold  are  not  fit  to  be  eaten.  The 
irritating  and  astringent  properties  of  certain  vegetable 
substances  were  doubtless  put  into  thorn  as  warnings 
against  their  use  by  human  beings. 

.In  Mexico,  where  pepper,  mustard,  and  other  con- 
diments are  probably  us<?d  more  freely  than  in  any 
other  part  of  the  world,  gastric  catarrh  is  an  almost 
universal  disease. 

In  the  case  of  salt,  there  are  several  objections  to 
be  urged,  which  are  at  least  cogent  against  its  excessive 
use  ;  and  by  excessive  use  is  meant  a  quantity  which 
causes  thirst  either  at  or  after  meals,  occasioned  by  the 
feverish  state  of  the  stomach  induced  by  the  caustic 
properties  of  the  saline  element.  According  to  De- 
bove,  physiological  experiments  have  shown  that  salt, 
when  taken  in  considerable  quantities,  interferes  with 
the^digestion  of  albumen.  This  statement  agrees  with 


MALADIES    OF    THE    STOMACH.  Ill 

the  writer' s  own  laboratory  experiments,  as  well  as  with 
the  experience  of  sailors,  who,  when  making  free  use 
of  salt  meat,  suffer  from  scurvy  and  a  long  list  of  symp- 
toms indicating  malnutrition  and  tissue  starvation.  Ex- 
perimental evidence  shows  that  human  beings,  as  well 
as  animals  of  all  classes,  live  and  thrive  as  well  without 
salt  as  with  it,  other  conditions  being  equally  favorable: 
This  statement  is  made  with  a  full  knowledge  of  coun- 
ter arguments  and  experiments,  but  not  without  abun- 
dant testimony  to  support  the  position  taken. 

The  author  does  not,  except  in  rare  instances,  advise 
the  entire  discontinuance  of  the  use  of  salt ;  neverthe- 
less, he  believes  that  it  may  be  greatly  re'duced  in 
quantity  by  all  who  use  it,  without  detriment,  and 
with  real  benefit.  Leriche  and  others  have  shown  that 
salt,  even  in  so  small  a  proportion  as  one  per  cent., 
diminishes  both  the  amount  and  the  efficiency  of  the 
hydrochloric  acid  of  the  gastric  juice,  and  thus  gives 
rise  to  fermentation,  one  of  the  most  common  symp- 
toms of  indigestion,  and  a  cause  of  many  other  morbid 
conditions. 

Salted  food  is  very  hard  of  digestion  ;  and  when  it 
is  taken  for  a  long  time,  the  stomach  often  fails.  A 
piece  of  fresh  fish  which  will  digest  well  in  one  hour 
and  a  half,  requires  four  hours  after  salting,  according 
to  Dr.  Beaumont. 

Pickles. —  Cucumbers,  peaches,  green  tomatoes, 
and  numerous  other  fruits  and  vegetables  are  sometimes 
preserved  by  saturation  with  ^strong  vinegar.  Some- 
times whisky  or  some  other  alcoholic  liquor  is  added  to 
increase  the  preservative  property  of  the  vinegar;  but  the 
same  process  which  makes  it  impossible  for  the  fruit  or 
vegetable  to  ferment  or  decay,  makes  its  digestion 


112  THE    STOMACH. 

equally  difficult,  if  taken  as  food.  Pickles  are  exceed- 
ingly unwholesome  as  an  article  of  diet,  and  are  often 
the  cause  of  acute  dyspepsia.  Those  addicted  to  the 
free  use  of  pickles  may  be  assured  that  they  must  cer- 
tainly part  with  their  favorite  dainty  or  bid  farewell  to 
good  digestion.  Cucumbers  preserved  with  salt  or  vin- 
egar are  next  to  impossible  of  digestion.  The  pro- 
verbial unhealthfulness  of  this  vegetable  is  a  popular 
notion  based  on  experience  with  the  article  prepared 
with  vinegar  and  salt.  These  chemical  agents  harden 
the  delicate  structures  of  the  vegetable,  and  render  it 
almost  unapproachable  by  the  digestive  juices.  The 
pure  vegetable,  unsophisticated  by  condiments,  is  no 
more  harmful  than  other  green  vegetables. 

Vinegar. — As  the  use  of  vinegar  is  continually  in- 
creasing, attention  should  be  called  to  the  fact  that  it 
may  be  a  cause  of  disease.  Ordinary  vinegar  con- 
tains about  five  per  cent,  of  acetic  acid,  its  principal  in- 
gredient. Like  alcoholic  liquors,  vinegar  is  a  product 
of  fermentation,  being  the  result  of  carrying  a  little 
farther  the  same  process  by  which  alcohol  is  produced. 
Vinegar  is  much  more  irritating  to  the  digestive  organs 
than  an  alcoholic  liquor  of  the  same  strength.  Its 
exciting  nature  makes  it  extremely  debilitating  to 
the  stomach.  Dr.  William  Roberts,  of  England,  has 
shown  that  so  small  a  proportion  of  vinegar  as  one 
per  cent.,  completely  arrests  the  action  of  the  saliva 
upon  starch.  The  writer's  own  experiments  have  con- 
firmed the  observations  of  J)r.  Roberts. 

The  moderate  use  of  a  light  wine  or  of  ale  or  beer 
is  much  less'destructive  to  the  digestive  organs  than  a 
free  use  of  vinegar.  This  remark  is  made,  not  to  com- 


MALADIES    OF  THE    STOMACH.  113 

mend  wine  or  beer,  however,  since  these  substances  are 
possessed  of  no  virtue,  and  are  capable  of  doing  a  vast 
deal  of  harm.  There  is  really  no  need  of  resorting  to  so 
inferior  a  source  for  a  mild  acid,  as  we  have  the  want 
met  most  perfectly  in  lemons,  limes,  citrons,  and  other 
acid  fruits.  As  a  dressing  for  some  kinds  of  vegetable 
foods,  lemon  juice  is  a  perfect  substitute  for  vinegar. 
Recent  observations  have  shown  that  the  vinegar  eels 
which  are  nearly  always  to  be  found  in  ' '  good  cider 
vinegar, ' '  often  take  up  their  abode  in  the  alimentary 
canal,  becoming  intestinal  para- 
sites, and  producing  much  mis- 
chief. (Fig.  16.) 

Vinegar  is  often  adulterated, 
containing  a  very  small  propor- 
tion, if  any  at  all,  of  real  apple- 
juice,  its  acidity  being  due  to 

hydrochloric  or    sulphuric  acid  ; 

,,  .  FIG.  16.— VINEGAR  EELS. 

therefore   such   vinegar   is   even 

more  destructive  to  the  functions  of  the  stomach  and 
also  to  the  teeth  than  ordinary  vinegar. 

Tea  and  Coffee.—  Classing  these  favorite  bev- 
erages with  causes  of  dyspepsia  will  certainly  call  forth 
.  a  loud  protest  from  the  numerous  devotees  of  < '  the  fra- 
grant cup,"  as  among  the  number  of  those  who  argue 
for  their  use  are  numerous  learned  professors,  as  well 
as  nearly  the  whole  sisterhood  of  the  maidens,  wives, 
mothers,  and  grandmothers  of  the  nation,  along  with 
a  good  proportion  of  the  brothers,  husbands,  fathers, 
and  grandfathers  also.  Nevertheless,  it  can  be  easily 
shown  that  whatever  action  may  be  assigned  to  these 
beverages,  it  is  unfavorable  to  digestion,  rather  than 
8 


THE    STOMACH. 

otherwise.  Leaving  out  of  consideration  the  objections 
which  may  be  urged  against  the  use  of  tea  and  coffee 
on  other  grounds,  the  following  may  be  offered  as  rea- 
sons why  they  are  objectionable  on  account  of  exerting 
an  injurious  influence  upon  the  digestive  organs  :  — 

1.  Both  tea  and  coffee  contain  an  element  resem- 
bling tannin,  which  precipitates  or  neutralizes  the  pep- 
sin of  the  gastric  juice,  and  so  weakens  its  digestive 
power. 

2.  Thein   and  caff  em,  the   active  principles  of  tea 
and  coffee,  are  toxic  elements  which  diminish  the  activ- 
ity of  the  glands  of  the  stomach  by  which  the  gastric 
juice  is  formed,  thus  interfering  with  the  digestion  of 
albumen  and  other  proteid  substances. 

3.  Both   tea  and  coffee   are  objectionable   on   the 
same   ground  as   other   beverages  in  connection  with 
meals,  on  account  of  their  disturbing  the  digestion  by 
dilution  and  consequent  weakening  of  the  gastric  juice, 
and  by  overtaxing  the  absorbents,  thus  delaying  the  di- 
gestion of  the  food,  and  giving  rise  to  fermentation. 

4.  Experiments  made  by  Dr.  William  Roberts,  and 
repeated  by  the  writer,  show 'that  tea,  even  in  a  com- 
paratively small  amount,  destroys  the  starch-digesting 
properties  of  the  saliva, — another  fact  which  accounts  for 
the  universal  existence  of  indigestion  in  tea  and  coffee 
drinkers. 

Alcohol. —  We  have  not  space  in  this  connection 
to  dwell  at  length  upon  the  damaging  effects  of  alcohol 
upon  the  human  system,  nor  the  full  details  of  its  effects 
upon  the  stomach.  The  following  facts,  however, 
are  well  worth  the  consideration  of  those  who  believe 


MALADIES    OF    THE    STOMACH.  115 

in  the  use  of  alcohol  either  moderately  or  with  greater 
freedom  :  — 

1.  Alcohol  itself  is  an  active  poison,  which  when 
received  into  the  stomach  in  a  concentrated  state,  is 
almost  as  quickly  fatal  to  life  as  is  prussic  acid  or 
strychnia.  It  precipitates  the  pepsin  of  the  gastric 
juice,  rendering  it  inert. 

•2.  It  irritates  the  gastric  mucous  membrane  when 
taken  in  any  but  extremely  small  quantities,  even  beer 
and  the  weaker  liquors  having  this  effect  when  long 
continued. 

3.  The  ultimate  effect  of  alcohol  is  to  cause  degen- 
eration of  the  secreting  glands  of  the  stomach,  by  which 
its  utility  as  a  digesting  organ  is  destroyed. 

Sir  William  Roberts,  the  eminent  English  physician 
whose  authority  we  have  already  quoted,  has  shown 
that  alcohol  diminishes  the  activity  of  gastric  digestion. 
In  experiments  made  by  the  writer  in  the  Laboratory 
of  Hygiene  (Battle  Creek,  Mich.,  U.  S.  A.)  it  has  been 
found  that  half  a  pint  of  light  wine  lessens  the  digest- 
ive activity  more  than  one  half  ;  and  that  an  ounce  of 
alcohol,  well  diluted,  almost  completely  arrests  stom- 
ach digestion. 

Dr.  Beaumont's  observations  on  the  effects  of  alco- 
hol are  very  positive  and  distinct  in  their  indications. 
St.  Martin  being  an  intemperate  man,  occasionally  in- 
dulging freely  in  drink,  Dr.  Beaumont  had  an  oppor- 
tunity of  observing  the  effects  of  its  use,  as  by  the  aid 
of  a  strong  light  he  could  look  directly  into  his  patient's 
stomach  through  the  window  provided  by  the  remark- 
able accident  from  which  he  had  suffered.  After  he  had 


116  THE    STOMACH. 

been  drinking  freely  for  several  days,  Dr.  Beaumont 
found  the  mucous  membrane  exhibiting  inflamed  and 
ulcerous  patches,  and  the  secretions  very  greatly  viti- 
ated, the  gastric  juice  being  diminished  in  quantity, 
viscid,  and  unhealthy,  although  St.  Martin  tlid  not 
complain  of  any  unusual  feelings,  and  his  appetite  being 
apparently  unimpaired.  The  condition  continued  to 
become  still  more  aggravated  for  a  day  or  two,  when 
the  doctor  found,  to  use  his  own  words,  that  ' '  the 
inner  membrane  of  the  stomach  was  exceedingly  mor- 
bid, the  erythematic  appearance  more  extensive,  and 
the  spots  still  more  livid.  From  the  surface  of  some 
of  them  exuded  small  drops  of  grumous  blood  ;  the 
aphthous  patches  were  large  and  very  numerous,  the 
mucous  covering  thicker  than  common,  and  the  gastric 
secretions  very  greatly  vitiated.  The  gastric  fluids 
extracted  were  mixed  with  a  large  proportion  of  thick, 
ropy  mucus,  and  a  considerable  muco-purulent  dis- 
charge slightly  tinged  with  blood,  resembling  the  dis- 
charge from  the  bowels  in  some  cases  of  dysentery." 

It  will  be  remarked  that  notwithstanding  the  very 
serious  condition  of  his  stomach,  St.  Martin  was  un- 
conscious of  any  great  disturbance  there.  This  was 
partly  due,  no  doubt,  to  the  paralyzing  effect  of  alcohol 
upon  the  nerves  of  sensibility.  It  is  owing  to  this  fact 
that  so  many  suppose  that  alcoholic  drinks  have  no 
specially  bad  influence  upon  the  stomach,  when  really 
their  stomachs  are  well-nigh  useless  from  disease,  but 
too  insensitive  to  indicate  their  condition. 

The  popular  idea  that  beer,  ale,  and  other  similar 
liquors  are  very  nourishing,  has  been  shown  to  be  an 
error.  Alcohol  is  in  no  sense  a  food.  Professor  Lie- 


MALADIES    OF   THE    STOMACH.  117 

big,  the  eminent  German  chemist,  has  shown  by  care- 
ful analysis  that  the  amount  of  nutriment  contained  in 
a  whole  hogshead  of  the  best  German  beer  is  less  than 
that  contained  in  one  ordinary  loaf  of  bread. 

Tobacco. —  Not  infrequently,  though  less  often 
than  is  the  case  with  alcoholic  liquors,  this  narcotic  drug 
is  recommended  as  a  remedy  for  dyspepsia.  Neverthe- 
less, in  the  case  of  tobacco,  as  in  that  of  alcohol,  the 
remedy  suggested  is  itself  an  active  cause  of  stomach 
disease.  Only  on  the  similia  similibus  plan  could 
either  one  be  reasonably  employed.  Both  smoking  and 
chewing  weaken  and  debilitate  the  digestive  organs, 
though  both  of  these  practices  are  thought  by  those  who 
indulge  in  them,  to  stimulate  the  process  of  digestion. 
This  it  probably  does  for  the  time  being,  but  only  at 
the  expense  of  subsequent  injury.  Snuff-taking,  espe- 
cially, produces  gastric  irritability,  probably  by  reflex 
sympathy  of  the  mucous  membrane  of  the  stomach  with 
that  of  the  nasal  cavity,  which  is  irritated  by  the  direct 
contact  of  the  acrid  drug. 

The  idea  that  tobacco  is  beneficial  because  of  its 
supposed  antiseptic  properties,  in  that  it  may  aid  diges- 
tion by  disinfecting  the  mouth,  is  without  founda- 
tion, since  the  teeth  of  tobacco  users  are  no  less,  prone 
to  decay  than  those  of  other  people,  and  cancer  of  the 
mouth,  one  of  the  most  fatal  and  incurable  of  germ 
diseases,  is  almost  exclusively  confined  to  tobacco  users. 
Tobacco  users  are  also  no  less  subject  to  pneumonia, 
consumption,  and  other  maladies,  the  germs  of  which 
enter  the  body  through  the  mouth  and  nose,  than  are 
other  people. 

The  immense  waste  of  saliva  occasioned  by  chewing 


1  1  N  THE    STOMACH. 

and  smoking  may  fairly  be  considered  as  one  of  the 
means  by  which  the  system  sustains  loss  and  injury 
through  the  use  of  tobacco.  An  eminent  physiologist 
reported  the  loss  of  several  pounds  in  a  week,  as  the 
result  of  the  stimulation  of  the  flow  of  saliva  by  con- 
stant mastication  for  experimental  purposes.  This  ex- 
plains the  loss  of  flesh  in  cases  of  tobacco  using  ;  and 
there  is  an  equivalent  loss  of  strength.  It  is  apparent 
that  the  loss  of  flesh  is  also  in  part  attributable  to  the 
physical  damage  of  the  body  by  the  poisonous  nico- 
tine,—  certainly  a  very  doubtful  sort  of  remedy. 

Those  who  chew  or  smoke  to  prevent  excess  of  fat, 
should  understand  that  any  drug  which  will  exert  such 
#n  influence  upon  the  system  must  be  a  powerfully  de- 
structive agent.  Those  who  succeed  in  keeping  down 
fat  by  the  use  of  tobacco  may  depend  upon  it  that  they 
are  doing  so  only  at  the  ruinous  expense  of  their  digest- 
ive organs,  and  may  look  forward  with  certainty  to  the 
breaking  down  of  the  nervous  system. 

Hard  Water. — So  little  attention  has  been  paid 
to  this  really  common  cause  of  indigestion  by  writers  on 
this  subject,  that  we  cannot  forbear  mentioning  it  here. 
Experience  has  often  proved  that  the  use  of  hard  water 
impairs  the  integrity  of  the  stomach  sooner  or  later, 
when  long  continued  ;  and  in  numerous  instances  its 
effects  are  almost  immediate  upon  persons  who  visit  a 
hard-water  district,  having  been  accustomed  to  the  use 
of  soft  water.  The  cause  of  these  injurious  effects  is 
undoubtedly  attributable  to  the  lime  and  magnesia 
which  are  contained  in  water  called  hard.  These  alka- 
lies, as  already  seen  in  considering  the  physiology  of 
digestion,  neutralize  the  gastric  juice,  and  thus  work 


MALADIES    OF   THE    STOMACH.  119 

mischief.  There  is  little  necessity  for  the  use  of  hard 
water  in  any  part  of  this  country.  Where  there  are 
not  soft-water  wells  or  springs,  rain-water  may  be 
caught  and  preserved  in  cisterns,  and  by  boiling  and  fil- 
tration through  carbon  filters,  made  pure  and  palatable 
for  drinking  and  cooking  purposes.  Boiling  hard  water 
greatly  diminishes  its  hardness  by  precipitating  the  lime 
which  it  contains.  There  is  no  foundation  for  the  theory 
that  hard  water  is  in  any  respect  more  excellent  for  use 
than  pure  soft  water.  Distillation  is  the  most  efficient 
of  all  means  of  securing  pure  water.  A  very  convenient 
and  inexpensive  apparatus  for  distillation  is  manufac- 
tured by  the  Modern  Medicine  Co. ,  Battle  Creek,  Mich. 
Alkalies. — For  the  same  reason,  soda,  saleratus, 
and  the  numerous  compounds  of  these  substances  with 
ammonia,  alum,  cream  of  tartar,  etc.,  are  all  objection- 
able on  the  same  grounds  as  hard  water.  Being  alka- 
line, they  antagonize  the  action  of  the  acid  gastric  juice, 
and  thus  weaken  digestion.  There  is  no  more  active 
dyspepsia-producing  agent  than  soda  or  saleratus  bis- 
cuit, one  of  the  most  common  articles  of  food  to  be 
found  on  the  tea-tables  of  rich  and  poor  in  this  country. 
Doubtless  well-prepared  baking-powders  are  much  pref- 
erable to  soda  and  cream  of  tartar  or  saleratus  and  sour 
milk,  mixed  by  the  cook  in  accordance  with  the  not  re- 
markably accurate  ' '  rule  of  thumb, ' '  through  which 
bungling  chemistry  the  biscuit  often  present  a  golden 
hue,  which  may  be  quite  attractive  to  the  eye,  but  gives 
to  the  tongue  quite  too  distinct  a  flavor  of  soda  and  pot- 
ash to  be  agreeable  to  a  fastidious  taste,  to  say  nothing 
of  the  probable  effect  upon  a  stomach  not  impregnable 
to  the  attacks  of  chemical  agents.  In  baking-powders, 


120  THE    STOMACH. 

the  various  ingredients  are  so  mixed  as  to  leave  nearly 
neutral  products,  and  yet  these  compounds  are  scarcely 
less  pernicious  in  their  influence  upon  digestion  than 
the  original  chemicals  from  which  they  are  formed. 

The  constituents  of  the  best  baking-powders,  when 
mixed  with  water,  are  essentially  the  same  as  those  of 
Rochelle  salts.  Many  baking-powders  contain  alum, 
and  nearly  all  contain  more  or  less  ammonia.  Both  of 
these  substances  have  been  shown  to  be  extremely  det- 
rimental to  the  digestive  organs.  Careful  chemical 
tests  made  by  the  writer  and  by  others,  have  shown  that 
ammonia,  when  used  as  a  raising  agent,  is  driven  off 
by  the  heat  only  to  a  small  extent,  a  sufficient  amount 
remaining  to  occasion  great  damage  to  the  digestive 
functions. 

Alkalies  of  all  kinds  are  injurious  to  digestion  be- 
cause of  their  neutralizing  the  gastric  juice,  flypo- 
pepsia  and  apepsia  result  from  a  long-continued  use  of 
alkaline  substances  in  the  food  or  for  the  relief  of 
sour  stomach,  acidity,  etc. 

Perverted  Appetites. —  Strangely  perverted 
tastes,  as  shown  in  a  fondness  for  earthy  and  other  in- 
organic or  innutritions  substances,  while  sometimes  the 
resuty  of  dyspepsia,  are  often  the  cause  of  stomach  dis- 
orders. They  are  either  the  result  of  nervous  or  men- 
tal disease,  or  are  adopted  as  a  habit  through  example. 
In  South  America  there  are  whole  tribes  of  human  beings 
who  habitually  eat  considerable  quantities  of  a  peculiar 
kind  of  clay.  Several  North  American  tribes  have  the 
same  habit,  being  known  as  clay-eaters.  A  similar 
propensity  sometimes  appears  among  more  civilized 
human  beings,  being  almost  exclusively  confined,  how- 


MALADIES    OF    THE    STOMACH.  121 

ever,  to  young  women,  chiefly  schoolgirls,  who  acquire 
the  habit  of  chewing  up  slate  pencils,  and  gradually  be- 
come so  fond  of  such  earthy  substances  that  they  have 
in  some  instances  been  known  to  eat  very  considerable 
quantities  of  chalk,  clay,  and  similar  substances. 
While  indicating  a  depraved  state  of  the  system,  and 
often  of  the  mind  also,  this  practice  has  a  very  perni- 
cious effect  upon  the  stomach,  which  is  not  intended,  as 
is  that  of  the  fowl,  to  receive  inorganic  matter  of  that 
sort. 

The  amount  of  abuse  of  this  sort  which  the  stomach 
will  stand,  however,  is  quite  astonishing.  Dr.  Pavy 
tells  a  story  of  an  American  sailor  who  saw  a  juggler 
pretending  to  swallow  pocket-knives  With  the  char- 
acteristic recklessness  of  a  sailor,  and  supposing  that 
the  knives  were  really  swallowed,  he  attempted  to  do 
the  same  thing  himself,  and  succeeded  in  getting  down 
four.  Three  of  these  were  passed  off  in  a  day  or 
two,  but  he  never  saw  the  other.  Six  years  after,  he 
swallowed  fourteen  knives  in  two  days,  and  was  taken 
to  a  hospital,  where  "he  got  safely  delivered  of  his 
cargo."  He  was  not  so  fortunate  on  a  subsequent 
occasion,  when  he  paid  dearly  for  his  folly,  lingering  in 
misery  for  some  time  until  he  died,  when  his  stomach 
was  found  to  contain  a  number  of  rusty  knife-handles, 
blades,  springs,  etc. ,  the  organ  being  greatly  contracted 
and  corrugated  in  consequence  of  the  violence  which 
had  been  done  it.  As  a  general  rule,  the  innutritious 
parts  of  foods,  as  the  skins  of  fruits  and  vegetables,  the 
seeds  and  cores  of  apples  and  similar  fruits,  should  be 
carefully  separated  from  the  nutrient  portions,  and  dis- 
carded. 


THE    STOMACH. 

Adulterations  of  Food. —  The  numerous  adul- 
terations of  food  which  are  now  so  extensively  practiced 
must  be  recognized  as  a  not  unimportant  cause  of  func- 
tional disease  of  the  stomach.  Alum  in  bread  and 
in  baking-powders  ;  lead  in  drinking-water  which  has 
passed  through  lead  water-pipes,  or  has  been  stored  in 
lead  cisterns,  or  collected  from  a  roof  covered  with 
sheet-tin  containing  lead  ;  lead  occurring  in  the  tin  cans 
used  for  preserving  fruit,  or  in  tin  pans  or  other  tinned 
ware,  or  in  the  glazing  of  kettles  ;  vinegar  containing 
sulphuric  and  other  strong  mineral  acids  ;  pickles  boiled 
in  copper  or  brass  vessels,  and  thus  poisoned  with  cop- 
per ;  sugar  made  from  corn,  refuse  starch,  etc. ,  and  con- 
taining iron,  sulphuric  acid,  tin,  etc. ;  flavoring  extracts 
made  by  purely  chemical  processes,  and  containing  not 
a  drop  of  the  extract  of  the  fruit  after  which  they  are 
named, —  these,  with  numerous  other  equally  harmful 
adulterations,  may  be  reckoned  among  the  active  causes 
of  indigestion. 

Unseasonable  Diet. —  The  failure  to  recognize 
the  necessity  of  adapting  the  diet  to  the  season  and  cli- 
mate is  a  prolific  source  of  a  certain  class  of  dyspeptic 
disorders.  This  is  especially  noticeable  when  the  use  of 
large  quantities  of  carbonaceous  food,  especially  fats 
and  sugar,  which  may  be  used  in  the  winter  with  com- 
parative impunity,  is  continued  into  the  warm  season  of 
the  year  ;  or  when  a  diet  of  this  sort  is  continued  in  a 
warm  climate  by  persons  who  have  been  accustomed  to 
it  in  a  cold  country.  It  is  this  sort  of  transgression  of 
the  laws  of  digestion  that  gives  rise  to  "  spring  bilious- 
ness," "bilious  dyspepsia,"  etc.,  in  many  persons. 
Large  quantities  of  fat  and  sugar  are  not  well  tolerated 


MALADIES    OF    THE    STOMACH.  123 

by  the  stomach  at  any  time  ;  and  in  warm  climates,  and 
in  the  warm  season  of  cold  and  temperate  latitudes, 
they  are  exceedingly  injurious. 

Pressure  upon  the  Stomach. —  The  .stomach 
is  remarkably  sensitive  to -pressure.  It  even  sometimes 
becomes  temporarily  paralyzed  by  excess  in  eating,  or 
by  the  accumulation  of  gas  from  fermentation,  by  the 
distention  of  its  walls.  It  is  equally  liable  t'o  injury  of 
a  similar  sort  from  external  causes.  A  sudden  blow 
upon  the  stomach  has  been  known  to  produce  almost 
instant  death,  through  the  impression  made  upon  the 
sympathetic  nervous  system. 

The  wearing  of  corsets,  and  tight-lacing  with  or 
without  the  corset,  are  common  causes  of  dyspepsia,  as 
well  as  of  other  serious  diseases.  Wearing  the  panta- 
loons drawn  tight  and  without  suspenders  has  a  simi- 
lar effect  upon  men.  The  soldiers  of  the  Russian 
army  once  suffered  so  much  from  this  cause  that  it  be- 
came necessary  to  correct  the  evil  by  a  royal  edict  for 
the  purpose.  Very  soon  after  the  evil  practice  was 
discontinued,  the  effects  disappeared.  Bookkeepers 
and  school-children,  from  sitting  at  a  desk ;  seam- 
stresses and  tailors,  from  stooping  over  at  their  work  ; 
shoemakers,  weavers,  and  washerwomen,  from  direct 
pressure  upon  the  stomach  incidental  to  their  jsvork, 
are  apt  to  suffer  from  disturbance  of  that  organ. 

The  disturbances  produced  by  compression  of  the 
stomach,  constriction  of  the  waist,  or  bad  positions  in 
sitting  are  chiefly  due  to  displacement  of  the  stomach, 
resulting  in  too  long  retention  of  food,  thus  giving  ex- 
cellent opportunity  for  the  development  of  germs 
taken  in  with  the  food,  together  with  the  irritating 


THE    STOMACH. 


acids  and  poisonous  substances  which  result  from  their 
growth. 

Brain  Work.  —  Mental  labor,  if  agreeable  and 
pleasant,  is  a  most  healthful  occupation.  There  is  no 
evidence  for  believing  that  brain  work  of  that  sort  ever 
disagreed  with  the  stomach  or  .impaired  its  functions  in 
any  degree  ;  but  mental  worry,  discontent,  anxiety,  and 
gloom  are  most  unfavorable  conditions  for  digestion, 
and  under  their  influence  few  stomachs  can  long  main- 
tain their  integrity. 

Lack  of  Exercise.  —  Idleness  is  one  of  the  most 
unhealthful  of  conditions.  A  lazy  man  is  never  well. 
Exercise  aids  digestion  by  increasing  the  activity  of  the 
diaphragm  and  the  chest,  as  has  been  previously  ex- 
plained. It  is  also  useful  by  purifying  the  blood  and 
aiding  the  vigor  of  the  circulation.  The  detrimental 
influence  of  idleness  or  a  sedentary  life  upon  digestion 
is  very  clearly  shown  by  the  results  of  such  a  life  upon 
the  appetite.  In  a  normal  state  the  appetite  is  a  good 
index  to  the  condition  of  the  digestive  organs,  —  in  other 
words,  a  good  appetite  means  good  digestion  ;  loss  of 
appetite  means  loss  of  the  power  to  digest  food.  Out- 
door exercise  is  particularly  helpful  as  an  aid  to  diges- 
tion. Horseback  riding,  bicycle  riding,  and  rowing  are 
to  be  highly  commended. 

Mental  Impressions.  —  The  digestive  process  is 
very  greatly  under  the  control  of  the  mind.  The  con- 
nection between  the  mind  and  the  stomach  is  so  inti- 
mate that  Van  Helmont  maintained  for  a  long  time  that 
the  stomach  was  the  seat  of  the  soul.  By  any  strong 
emotion  the  whole  digestive  apparatus  may  suddenly 
cease  to  act.  Fear,  rage,  and  grief  check  the  salivary 


MALADIES    OF    THE    STOMACH.  125 

secretion,  and  without  doubt  the  gastric  also.  Through 
the  mind,  the  appetite  may  be  either  encouraged  or 
quite  destroyed.  It  seems  very  plausible  that  a  strong 
nervous  impression  might  so  affect  the  system  as  to  lay 
the  foundation  for  chronic  dyspepsia. 

A  man  who  sits  down  to  dinner  with  his  mind 
depressed  with  business  cares,  the  embarrassment  of 
debts,  or  the  anxiety  of  doubtful  speculations,  cannot 
hope  to  digest  the  most  carefully  selected  meal.  The 
woman  who  dines  with  her  mind  disturbed  with  discon- 
tent, fretfulness,  and  worriment,  is  certain  to  suffer 
with  indigestion.  Domestic  infelicity  may  well  be 
counted  as  at  least  an  occasional  cause  of  digestive 
derangements.  Meals  eaten  in  moody  silence  are  much 
more  apt  to  disagree  with  the  stomach  than  those  which 
are  accompanied  by  cheerful  conversation.  A  hearty 
laugh  is  the  very  best  sort  of  a  condiment.  Cheerful- 
ness during  and  after  meals  cannot  be  too  highly  rated 
as  an  antidote  for  indigestion. 

Drugs. —  The  continued  use  of  drugs  of  various 
kinds,  and  especially  of  patent  medicines,  ' '  bitters, ' ' 
and  purgatives,  particularly  the  latter,  has  a  very 
damaging  effect  upon  the  stomach  and  bowels.  Too 
much  cannot  be  said  to  discourage  the  use  of  laxatives, 
purgatives,  ' '  liver  pills, ' '  etc.  While  sometimes  bene- 
ficial, agents  of  this  kind,  if  used  for  any  length  of 
time,  are  quite  certain  to  work  mischief.  Purgatives 
should  never  be  used  except  as  temporary  palliatives. 
If  the  bowels  require  artificial  aid,  the  enema  is  far 
preferable  ;  and  yet  this  plan  also  has  its  inconven- 
iences, and  results  badly  if  too  long  continued.  In 
general,  the  less  drugs  are  used,  the  better.  Patent 


126  THE    STOMACH. 

nostrums  should  be  shunned  like  the  most  virulent  poi- 
sons, as  in  many  instances  they  are. 

Alkaline  laxatives  and  laxative  mineral  waters, 
when  used  for  any  considerable  length  of  time,  are 
exceedingly  damaging  ;  they  irritate  the  solar  plexus 
and  induce  hypopepsia. 

Sexual  Abuses. —  Although  this  is  not  the  place 
for  a  dissertation  on  the  subject  heading  this  paragraph, 
sexual  transgression  in  all  its  forms  must  be  set  down 
as  a  not  infrequent  cause  of  the  class  of  disorders  un- 
der consideration.  Secret  vice  in  the  young,  though 
often  unsuspected,  is  the  undermining  influence  which 
works  irretrievable  ruin  in  many  constitutions,  weaken- 
ing the  stomach  by  exhausting  the  nervous  energies 
upon  which  it  depends  for  support.  Marital  excesses 
have  the  same  effect,  and  in  essentially  the  same  w;iy, 
the  vital  forces  being  exhausted  more  rapidly  than  they 
can  be  replenished.  The  researches  of  Brown-Sequard 
and  his  successors  have  shown  that  continence  is  not 
only  consistent  with  perfect  health,  but  that  the  secre- 
tion of  the  sexual  glands  is  an  important  vital  stimulus, 
which  is  of  great  benefit  to  the  individual,  and  indispens- 
able as  a  controlling  element  in  the  development  of 
the  body. 

Disease  of  Other  Organs. —  The  nervous  con- 
nections of  the  stomach  and  its  associated  organs  are  so 
extensive  and  numerous,  involving,  of  course,  equally 
extensive  and  various  sympathies,  that  it  is  not  a  matter 
of  surprise  that  disease  of  other  parts,  through  direct 
sympathy,  or  through  a  general  influence  upon  the  whole 
system,  often  occasions  disease  of  the  stomach.  This 
is  so  generally  true  that  it  may  almost  be  said  that 


MALADIES    OF    THE    STOMACH.  l-i7 

' '  e\  ery  disease  has  its  accompanying  dyspepsia. ' '  This 
fact  is  particularly  observable  in  the  weakness  of  the 
digestive  organs  which  usually  follows  prolonged  fe- 
vers ;  which  accompanies  and  follows  malarial  diseases  ; 
and  which  is  closely  connected  with  rheumatic  and 
gouty  affections,  with  most  maladies  requiring  enforced 
rest  for  a  great  length  of  time,  with  most  forms  of  brain 
disorder,  and  with  nearly  every  form  of  organic  disease, 
as  well  as  with  structural  disease  of  the  stomach,  as 
simple  dilatation,  chronic  ulcer,  contraction,  cancer,  and 
other  abnormal  growths. 

Inherited  Dyspepsia. —  Many  patients  assert 
that  they  have  inherited  dyspepsia  from  a  dyspeptic 
father  or  mother,  having  suffered  from  their  earliest 
recollection  from  distress  after  eating,  or  other  disturb- 
ance of  the  digestive  functions.  In  many  of  these  cases 
there  is  doubtless  an  inherited  weakness  of  the  stomach, 
which  may  become  genuine  dyspepsia  by  a  very  slight 
deviation  from  the  laws  of  good  digestion  ;  yet  it  can 
hardly  be  supposed  that  dyspepsia  itself  is  inherited  in 
the  sense  that  some  other  diseases  are.  The  tendency 
or  predisposition  may  be  inherited  in  the  form  of  a 
weak  stomach  ;  but  in  most,  if  not  all,  of  these  cases, 
careful  inquiry  will  show  that  the  disease  itself  is  due  to 
bad  feeding  or  some  other  mismanagement  in  infancy. 
The  use  of  nursing-bottles  without  proper  attention  to 
cleanliness,  which  is  indeed  impossible  when  a  long  tube 
is  used  ;  the  employment  of  deceptive  mixtures  sold 
as  ' '  infant  food  ; ' '  and  especially  the  use  of  paregoric, 
' '  Mrs.  Winslow'  s  Soothing  Syrup, "  "  worm  teas, ' ' 
vermifuges,  and  other  powerful  drugs,  with  an  infinite 
variety  of  teas,  sirups,  and  other  patent  and  domestic 


128  THE    STOMACH. 

compounds, —  these  are  some  of  the  more  powerful 
influences  which  occasion  early  dyspepsia,  and  often 
entail  lifelong  misery  and  suffering.  An  individual 
who  has  grown  up  to  manhood  or  womanhood  under 
the  gloomy  shadow  of  an  ever-present,  depressing,  de- 
spair-producing dyspepsia,  can  never  fully  see  the  sunny 
side  of  life,  even  if  his  stomach  could  be  made  to  do 
its  duty.  The  mind  falls  into  habits  of  thought  and 
receives  a  certain  cast  in  early  life  that  no  influence  of 
after-years  can"  erase.  Hence  a  responsibility  rests 
upon  those  who  have  the  care  of  the  diet  of  human 
beings  at  the  beginning  of  life  which  is  really  fearful, 
in  view  of  the  immediate  and  remote  consequences  to 
the  victims  of  improper  management. 

A  number  of  observations  made  by  the  writer  have 
led  him  to  the  conclusion  that  dilatation  of  the  stomach, 
a  common  condition  in  cases  of  chronic  dyspepsia,  often 
begins  in  infancy  or  early  childhood.  The  overfeeding 
of  children  and  the  overdistention  of  the  stomach  with 
gas, —  the  natural  result  of  the  use  of  candy,  sweet- 
meats, cake,  and  various  other  unwholesome  and  indi- 
gestible foods, —  frequently  result  in  permanent  injury 
to  the  stomach,  the  consequence  of  which  is  lifelong 
suffering  from  indigestion  and  all  the  various  inconven- 
iences of  constitutional  maladies  arising  therefrom. 

Undetermined  Causes. —  No  doubt  there  are 
many  causes  of  disorders  of  the  stomach  which  affect 
it  indirectly,  through  the  nervous  system,  and  have  not 
as  yet  been  sufficiently  studied  to  receive  their  due 
weight.  Among  these  may  probably  be  classed  such 
influences  as  atmospheric  or  meteorological  changes. 
I  have  often  met  with  individuals  who,  though  having 


fT9    I 


-I/  f. 


r.,1. 


vV- 


flf   SO 


•V 

«/•«, 


flj  fj 


f,9  St. 


\  \ 


M 
fl 


PLATE  II. 


Animalcules  and  Infusoria  in  "Water. 
PLATE  III. 


MALADIES    OF    THE    STOMACH.  129 

no  difficulty  with  digestion  ordinarily,  whenever  a  falling 
barometer  indicated  diminished  atmospheric  pressure, 
and  clouds  covered  the  sky,  would  suffer  great  disturb- 
ance of  digestion.  Similar  results  will,  in  some  cases, 
almost  invariably  follow  the  electrical  disturbances 
which  precede  and  accompany  a  thunder  shower. 

Impure  Water. —  The  discovery  of  the  fact  that 
most  of  the  symptoms  of  indigestion  are  due  to  the  de- 
velopment of  germs  in  the  stomach  and  the  influence  of 
the  poisons  which  they  produce  upon  the  stomach  and 
remote  organs,  through  their  absorption  into  the  blood 
and  their  action  upon  the  sympathetic  nerves,  has  made 
very  clear  the  relation  of  impure  water  to  digestion. 
Impure  water  always  contains  germs  capable  of  setting 
up  fermentation  and  putrefaction  in  food  substances 
within  the  stomach.  Cold  water  taken  into  the  stom- 
ach checks  the  secretion  of  the  gastric  juice  and  the 
process  of  digestion,  thus  giving  the  germs  introduced 
with  the  water  an  opportunity  to  set  up  fermentative 
and  putrefactive  changes  in  the  food,  whereby  are  pro- 
duced acidity,  flatulence,  biliousness,  and  sometimes 
even  nausea  and  vomiting. 

The  accompanying  plate  ( Plate  II )  presents  some 
of  the  more  common  forms  of  germs  with  which  the 
modern  science  of  bacteriology  has  rendered  us  famil- 
iar. Plate  III  shows  some  of  the  numerous  forms  of 
small  organisms,  animal  and  vegetable,  which  are  to  be 
found  in  water  obtained  from  natural  sources. 


IMPORTANT  NEW  DISCOVERIES  RE- 
LATING  TO  DIGESTION. 


WITHIN  the  last  twenty-five  years,  but  especially 
during  the  last  decade,  immense  progress  has  been  made 
in  the  study  of  the  disorders  of  digestion,  and  especially 
in  the  methods  of  examining  both  the  stomach  as  regards 
its  physical  condition,  and  also  the  products  of  digestion. 
This  subject  is  somewhat  too  abstruse  for  the  unprofes- 
sional reader  ;  but  a  brief  resume  of  some  of  the  more 
important  facts  relating  to  recent  progress  in  methods 
of  examination  of  the  stomach  and  investigation  of  its 
disorders  can  scarcely  fail  to  be  interesting  even  to  non- 
medical  readers. 

The  most  important  discovery  which  has  been  made  in 
modern  times  in  relation  to  the  examination  of  the  stom- 
ach is  the  method  sometimes  termed  ' '  tubage, ' '  which 
consists  in  introducing  into  the  stomach  a  soft  or  semi-soft 
and  very  smooth  and  flexible  rubber  tube.  This  tube  is 
not  forced  into  the  stomach,  as  was  the  case  with  the  tube 
of  the  old-fashioned  stomach-pump,  but  is  simply  placed 
in  the  mouth  so  that  the  end  of  the  tube  touches  the. 
back  part  of  the  throat,  where,  being  grasped  by  the 
muscles  of  the  throat  in  the  act  of  swallowing,  it  is 
quickly  carried  down  into  the  stomach.  By  means  of 
the  stomach-tube  it  is  possible,  by  an  actual  measure- 
ment of  the  quantity  of  fluid  which  the  stomach  will 
hold,  to  form  a  very  accurate  estimate  of  its  size.  It  is 
also  possible  to  determine  whether  the  stomach  empties 
[130] 


NEW    DISCOVERIES    gELATING    TO    DIGESTION.  131 

itself  completely,  and  how  long  a  time  elapses  after  eat- 
ing before  the  stomach  has  disposed  of  its  food  con- 
tents by  passing  the  digesting  food  along  into  the  small 
intestines.  Many  other  facts  relating  to  the  work  of 
the  stomach  can  be  determined  by  this  means,  but  these 
will  be  spoken  of  later. 

Various  methods  have  also  been  devised  for  deter, 
mining  the  size  and  location  of  the  stomach  without  the 
use  of  the  stomach-tube.  One  of  the  most  ingenious  of 
these  is  the  distention  of  the  stomach  with  gas  by  gen- 
erating carbonic  acid  gas  in  the  stomach.  For  this  pur- 
pose the  patient  is  first  given  bicarbonate  of  soda 
dissolved  in  a  little  water,  then  tartaric  acid,  also  dis- 
solved in  water.  The  meeting  of  these  two  substances 
in  the  stomach  gives  rise  to  the  development  of  a  quan- 
tity of  carbonic  acid  gas.  The  quantity  of  chemicals 
introduced  must  be  varied  somewhat,  of  course,  accord- 
ing to  the  age  and  the  size  of  the  patient.  This  method 
is  not  very  much  used,  however,  on  account  of  its  incon- 
venience, and  the  possibility  of  injury,  especially  in 
cases  of  ulceration  of  the  stomach,  in  which  serious 
damage  might  be  done  by  a  rupture  of  the  weakened 
stomach  walls  at  the  seat  of  the  ulcer. 

Another  method  of  determining  the  position  of  the 
stomach  is  that  known  as  clapotement,  which  was 
devised  by  a  French  physician.  This  method  depends 
upon  the  fact  that  agitation  of  the  stomach  when  both 
fluid  and  air  are  present  in  it,  gives  rise  to  plashing 
sounds  which  can  be  easily  heard  by  the  unaided  ear, 
and  can  be  very  accurately  located  by  means  of  the 
stethoscope,  an  instrument  used  also  for  examination  of 
the  lungs  and  the  heart. 


132  THE  STOMACH. 

Another  method,  which  the  author  had  the  good  for- 
tune to  discover  a  few  years  ago,  is  what  might  be 
termed  "simple  palpation."  By  this  method  careful 
examination  of  the  stomach  is  made  with  reference  to 
the  presence  or  absence  of  fluid.  If  plashing  sounds 
are  not  heard,  then  the  patient  is  made  to  drink  water 
as  before.  After  the  water  has  been  taken,  the  physi- 
cian, standing  upon  the  right  side  of  the  patient,  places 
his  right  hand  upon  the  abdomen  just  below  the  ribs  of 
the  right  side  and  to  the  right  of  the  median  line  ;  while 
the  fingers  of  the  other  hand  are  placed  upon  the  cor- 
responding point  of  the  left  side.  Movements  are  then 
made  by  the  right  hand  of  a  character  calculated  to  agi- 
tate the  contents  of  the  stomach  ;  while  with  the  left 
hand  careful  observation  is  made  of  the, presence  or  ab- 
sence of  the  sign  of  "fluctuation."  In  case  the  patient 
is  not  too  fleshy,  the  movement  of  the  liquid  from  one 
side  of  the  stomach  to  the  other,  resulting  from  the  agi- 
tation with  the  right  hand,  gives  rise  to  impulses  which 
are  readily  recognized  by  the  left  hand,  as  the  fluid  set 
in  movement  by  the  right  hand  impinges  against  the 
wall  of  the  stomach,  and  communicates  the  impulse  to 
the  abdominal  wall  of  the  opposite  side.  After  some 
practice  the  movements  of  fluid  in  the  stomach  can  be 
readily  detected,  and,  by  directing  the  impulses  in  va- 
rious directions,  the  whole  outline  of  the  lower  border 
of  the  stomach  may  be  clearly  defined. 

This  method  seldom  fails  except  in  very  fleshy  sub- 
jects. In  order  to  locate  the  stomach  in  these  cases, 
the  author  has  constructed  a  special  instrument,  which 
consists  of  a  stomach-tube,  bearing  at  its  inner  ex- 
tremity a  small  electrical  contrivance  which  is  capable 


NEW    DISCOVERIES    RELATING    TO    DIGESTION.          133 

of  emitting  a  clicking  or  buzzing  sound  when  excited 
by  an  attenuating  electrical  current.  Passing  the  tube 
inside,  and  listening  with  the  stethoscope  while  the 
indicator  is  in  position,  it  is  very  easy  to  determine  the 
lowest  limit  to  which  the  tube  can  be  passed  ;  and  by 
making  movements  or  readjustments  of  the  instrument, 
the  outline  of  the  lower  border  of  the  stomach  can  be 
very  accurately  marked  out. 

This  is  the  method  commonly  employed  by  the 
writer  in  making  his  examinations  of  the  stomach.  By 
this  method  it  is  possible  for  one  sufficiently  experi- 
enced to  readily  mark  out  the  location  of  the  lower 
border  of  the  stomach  in  a  few  seconds,  and  to  dis- 
cover a  prolapse  of  the  stomach,  dilatation  of  the  stom- 
ach, or  a  pocket  in  the  stomach, —  conditions  one  or 
more  of  which  are  to  be  found  in  a  great  majority  of 
the  cases  of  chronic  dyspepsia. 

The  influence  of  these  abnormalities  in  size  and  posi- 
tion upon  digestion  will  be  referred  to  later.  The  ac- 
companying cuts  (Plate  IV)  are  illustrations  of  a  few 
of  the  abnormalities  which  the  writer  has  noted  in  his 
examining  office.  In  one  of  these  cases,  as  will  be 
noticed,  the  stomach  was  prolapsed  nearly  to  the  pubes. 
The  colon,  kidneys,  and  all  the  other  viscera  of  the 
abdomen  were  likewise  in  a  prolapsed  condition.  The 
kidney,  in  this  particular  case,  was  prolapsed  to  such  a 
degree  that  its  function  had  been  interfered  with,  and  it 
had  become  so  bad] iy  diseased  that  it  was  found  necessary 
to  remove  it.  Within  the  kidney  was  found  a  stone 
weighing  four  and  one-third  ounces.  The  disease  was 
evidently  the  outgrowth  of  the  malposition  of  the  kid- 
ney. Prolapse  of  the  stomach  and  dilatation  of  the 


134:  THE    STOMACH. 

stomach  and  colon  are  conditions  to  which  too  little 
attention  has  been  given.  It  is  probable,  also,  that 
prolapse  of  the  bowels  and  dilatation  of  the  stomach 
are  sometimes  the  result  of  indigestion  ;  but  prolapse 
of  the  stomach  must  certainly  be,  in  many  cases,  the 
cause  of  disturbance  of  the  digestive  function,  being 
itself  the  result  of  such  mechanical  causes  as  waist 
constriction  from  corset-wearing,  tight  waistbands,  or 
the  wearing  of  belts. 

Examination  of  the  Stomach  Contents.— 
The  examination  of  the  contents  of  the  stomach  ob- 
tained after  a  test  meal  is  of  still  greater  importance 
than  a  physical  examination,— •-  at  least  in  the  treatment 
of  functional  or  non-structural  diseases  of  the  stomach. 
The  stomach  contents  are  obtained  by  means  of  a  stom- 
ach-tube, which  has  already  been  described.  The  pa- 
tient is  given  a  test  meal  consisting  of  one  and  one-half 
ounces  of  dry  water-bread  or  two  ounces  of  ordinary 
baker's  bread,  with  eight  ounces  of  water.  Exactly 
one  hour  from  the  beginning  of  the  meal,  the  tube  is 
passed  into  the  stomach  and  the  contents  withdrawn. 
This  is  accomplished  much  more  easily  than  might  be 
imagined  ;  indeed,  few  persons  suffer  much  from  the 
withdrawal  of  the  test  meal,  although  in  occasional  in- 
stances the  attempt  to  introduce  the  tube  provokes  a 
spasm  in  the  throat  which  renders  the  passage  of  the 
tube  impossible. 

After  obtaining  the  stomach  fluid,  it  is  subjected  to 
a  most  critical  and  elaborate  examination.  The  method 
of  examination,  which  will  be  more  fully  described,  has 
been  compiled,  arranged,  and  perfected  by  the  author 


NEW    DISCOVERIES    RELATING   TO    DIGESTION.          135 

from  the  investigations  in  this  direction  by  many  other 
scientific  workers.  Some  portions  of  the  method  are 
quite  new,  being  the  result  of  the  author's  personal 
work  and  experience.  This  is  especially  true  in  refer- 
ence to  the  methods  of  determining  coefficients,  which, 
with  the  exception  of  one,  have  all  been  devised  and 
determined  by  him. 

The  methods  employed  in  testing  the  digestion  of 
starch,  while  not  new  to  chemistry,  have  not  been  pre- 
viously employed  in  studying  the  disorders  of  digestion. 
The  facts  determined  in  this  method  of  investigation, 
which  is  more  elaborate  and  thoroughgoing  than  any 
other  with  which  the  writer  is  acquainted,  will  be  found 
in  a  colored  chart  near  the  close  of  this  book,  together 
with  the  figures  obtained  in  an  actual  case  examined, 
in  which  the  amount  of  work  done  by  the  stomach  was 
greater  than  normal.  This  method  of  investigation  has 
been  developed  as  the  result  of  years  of  patient  research 
and  inquiry  on  the  part  of  many  different  investigators 
in  different  parts  of  the  world.  The  foundation  for  the 
method  employed  was  laid  by  Dr.  Golding  Bird,  of 
Guy's  Hospital,  London,  more  than  fifty  years  ago,  in 
the  discovery  that  the  acid  of  the  gastric  juice  is  hydro- 
chloric acid,  and  that  the  degree  of  activity  of  the  stom- 
ach in  the  digestion  of  albumen,  is  chiefly  dependent 
upon  the  presence  of  this  acid.  The  hydrochloric  acid 
of  the  gastric  juice  has  been  shown,  however,  to  be  not 
simply  the  ordinary  chemical  compound  known  as 
hydrochloric  acid,  or  muriatic  acid,  but  an  organic  hy- 
drochloric acid  which  is  possessed  of  much  greater  ac- 
tivity as  a  digestive  agent  in  combination  with  pepsin 
than  is  ordinary  hydrochloric  acid. 


136  THE    STOMACH. 

Dr.  Bird's  researches  were  within  a  few  years  re- 
viewed by  Hayem  and  Winter,  two  French  physiolo- 
gists, who  perfected  methods  for  determining  not  only 
the  amount  of  hydrochloric  acid  present  in  a  given 
specimen  of  gastric  juice,  but  the  amount  and  quality 
of  the  work  done  by  the  stomach  in  the  digestion  of  al- 
bumen. Ewald,  Boas,  and  other  German  physicians 
have  contributed  important  methods  for  determining 
other  facts.  Professor  Roberts,  of  England,  has  estab- 
lished a  convenient  method  of  studying  starch  diges- 
tion. The  writer,  though  not  pretending  to  any  special 
eminence  as  a  chemist  or  an  originator  of  new  methods 
of  study,  has  undertaken  to  combine  these  various  meth- 
ods, and  by  the  assistance  of  skilled  chemists  and  the 
advantage  of  experience  in  the  examination  of  more  than 
five  thousand  cases  has  perfected  the  method  of  study- 
ing disorders  of  digestion  herewith  presented.  A  brief 
explanation  of  the  several  facts  determined  by  this 
method  will  be  of  interest :  — 

1.  The  amount  of  stomach  fluid  is  normally  forty 
cubic  centimeters,   or  one  and  one-third  ounces  ;  that 
is,  of  the  eight  ounces  of  fluid  and  the  one  and  one-half 
to  two  ounces  of  solid  food,  taken  into  the  stomach,  all, 
with  the  exception  of  one  and  one-third  ounces,  should 
be  absorbed  at  the  end  of  one  hour,  or  pass  on  into 
the  small  intestine.     If  a  larger  amount  is  found,  the 
indication    is    slow   absorption ;    if   a   smaller   one   is 
found,  the  absorption  is  more  rapid  than  normal. 

2.  In  the  examination  of  a  large  number  of  cases 
the  average  residue  left  after  filtration,  is  found  to  be, 
in  healthy  persons,  twenty  grams,  or  about  one  half 
the  total  amount  obtained.     A  larger  residue  than  this, 


NEW    DISCOVERIES    RELATING    TO    DIGESTION.          137 

or  a  larger  proportion  of  residue,  indicates  deficient 
activity  of  the  digestive  fluids  in  dissolving  the  food, 
or  delayed  solution. 

3.  If  the  residue  presents  masses  of  food  of  con- 
siderable size,   it  is  evident  that  mastication  has  been 
insufficient. 

4.  The  presence  of  a  large  amount  of  mucus  indi- 
cates gastric  catarrh. 

5.  A  greenish  or  yellow   color   usually  indicates 
bile  ;  a  red  color,  blood. 

6.  The  odor  of  putrescence  indicates  decay  ;  a  sour 
odor  indicates  the  presence  of  acetic  acid. 

7.  A  red  color,   or  the  presence  of  any  unusual 
appearance,   should  lead  to  a  careful  microscopic  ex- 
amination by  which  the  presence  of  pus  or  germs  may 
be   readily    determined.     A  thorough   examination  of 
the  germs  or  microbes  present  includes  a  cultivation 
of  the  germs  by  mixing  a  few  drops  of  stomach  fluid 
with  a  proper  culture  medium,  and  subsequent  staining 
or  microscopic  examination  by  ordinary  bacteriological 
methods. 

8.  The  digestive  agents  which  have  been  found 
present  in  the  stomach  fluid  are  next  investigated  by 
means  of  color  a-nd  other  reactions.     Those  of  the  most 
importance  are  hydrochloric  acid,  pepsin,  and  the  ren- 
net or  lab-ferment.     Examination  is  also  made  for  the 
presence  of  bile.     If  any  of  these  substances  are  ab- 
sent, the  effect  is  indicated  by  zero  ;  if  present,  by  a 
simple  -f-  sign  ;  if  in  an  unusual  quantity,  by  ++. 

9.  Recent  discoveries  in  physiological    chemistry 
have  made  it  possible  to  investigate  with  almost  per- 
fect accuracy  the  different  products  of  the  digestion  of 


138  THE    STOMACH. 

albumen,   or   rather  the   products  which  are  found  in 
'the   different   stages   of    the    conversion    of    albumen 
into  peptone,  the   final   product   of   the   digestion    of 
albumen. 

10.  By  means  of  the  reaction  with  a  solution  of  a 
compound  of  iodine,  a  very  good  idea  may  be  obtained 
respecting  the  conversion  of  starch  into  dextrin  or  malt- 
sugar,  the  reaction  showing  in   succession  the  colors, 
blue,  violet,  brown,  and   yellow  while  the  change  is 
taking  place,  until  the  solution  becomes  colorless. 

11.  By  methods  whiclj  have  been  largely  developed 
in  the  Sanitarium  Laboratory  of  Hygiene,  it  has  been 
found  possible  to  obtain  very  definite  data  respecting 
the  amount  of  fermentation  which  may  have  occurred  in 
the  case  of  any  particular  stomach  fluid.     Of  the  prod- 
ucts of   fermentation  found  in  the  stomach,   the  most 
common  are  lactic  and  acetic  acids.     Other  acids  and 
alcohol,  are,  however,  sometimes  found. 

12.  The  above    determinations  are    all    of  interest 
and  importance,  but  still  more  so  are  the  more  exact 
determinations  made  by ,  quantitative   analyses  of   the 
stomach  fluids,   whereby  the  degree  of    acidity   is   ac- 
curately determined,  together  with  the  amount  of  chlo- 
rin  found  in  the  different  conditions,  free,  combined, 
and  fixed.     The  significance  of  this  will  be  understood 
by  the  simple  mention  of  the  fact  that  the  gastric  juice 
depends,  for    its    digestive   activity,  upon   free  hydro- 
chloric acid,  and  that  when  fermentation  is  not  present, 
the  more  strongly  acid  the  gastric  juice,  the  greater  its 
digestive  vigor,  other  things  being  equal. 

13.  The  determinations   with   reference   to    starch 
have  been  undertaken  on  an  extensive  scale.     At  the 


NEW    DISCOVERIES    RELATING    TO    DIGESTION.          139 

present  writing,  these  determinations  have  been  made  in 
nearly  one  thousand  cases  in  the  Sanitarium  Laboratory 
of  Hygiene,  under  the  author's  direction.  The  deter- 
minations made,  are  (1)  with  reference  to  the  saliva, 
whereby  the  quantity  formed  and  its  activity  are  de- 
termined ;  (2)  the  amount  of  malt-sugar  or  maltose,  or 
completely  digested  starch,  formed  in  the  stomach  ;  (3) 
the  amount  of  dextrin  and  soluble  starch^  or  the  im- 
perfectly digested  starch. 

14.  By  accurate  chemical  methods  the  total  quan- 
tity of   acids  resulting  from   fermentation,    including 
lactic  and  acetic  acids,  is  determined. 

15.  A  careful  bacteriological  study  is  made  of  the 
stomach  fluid  for  the  purpose  of  determining  the  num- 
ber and  kind  of  germs  present,  the  number  found  vary- 
ing from  none  in  a  healthy  stomach  to  many  millions  in 
an  infected  stomach.    This  I  have  found  to  be  altogether 
the  most  exact  method  of  determining  the  condition  of 
the  stomach  as  regards  infection  and  the  resulting  ten- 
dency to  fermentation. 

The  experiments  made  show  conclusively  that  fer- 
mentation is  not  a  natural  process  in  connection  with 
digestion,  and  emphasizes  the  importance  of  suppress- 
ing germs  in  the  food,  so  far  as  possible. 

The  following  facts  are  readily  determined  by  this 
examination  :  — 

(1)  The  relative  number  of  germs  present. 

('2)  The  character  of  the  germs,  and  the  nature  of 
the  disturbance  which  they  produce  in  the  stomach. 

16.  Most  interesting  of  all  are  the  determinations 
relating  to  the  coefficients  of   digestive  work.      These 
coefficients  are  worked  out  from  the  data  furnished   by 


140  THE    STOMACH. 

quantitative  analysis.  The  indications  of  these  coeffi- 
cients are  as  follows  :  — 

a. —  This  coefficient  indicates  the  quality  of  the 
work  done  by  the  stomach  in  the  digestion  of  albumen. 
The  normal  is  1.00,  as  in  the  case  of  each  of  the 
coefficients.  In  the  present  case  the  coefficient  is 
found  to  be  .83,  indicating  that  the  work  done  by  the 
stomach  in  the  digestion  of  albumen  was  much  below 
par.  Still  another  fact,  however,  is  developed  by  this 
determination  ;  the  difference  between  the  coefficient 
and  1.00  indicates,  in  each  case  the  proportion  of 
the  vicious  products  of  the  digestion  of  albumen  formed 
in  the  stomach  and  thrown  into  the  circulation.  With  a 
coefficient  of  .50  the  indication  would  be  that  one  half 
the  albumen  digested  in  the  stomach  was  so  imper- 
fectly digested  as  to  be  of  no  value  as  food,  but  con- 
stituted, instead,  a  mass  of  poisonous  substances  which, 
after  absorption  into  the  blood,  must  be  destroyed  by  the 
liver  and  carried  out  of  the  body  through  the  kidneys. 

b. — This  is  the  coefficient  of  starch  digestion,  and 
indicates  how  nearly  the  process  of  starch  digestion  in 
the  stomach  approaches  completion. 

c. — This  coefficient  indicates  the  degree  of  efficient 
activity  of  the  salivary  glands.  It  expresses  both  the 
quantity  and  the  quality  of  the  saliva. 

X. —  This  is  the  coefficient  of  fermentation.  It  indi- 
cates the  relation  of  the  acidity  due  to  abnormal  acids 
to  the  total  acidity. 

y. —  This  is  the  coefficient  of  solution,  and  indicates 
the  degree  to  which  a  given  case  approaches  the  normal 
standard  of  twenty  grams  of  residue  to  40  c.c.,  or  one 
and  one-thircl  ounces,  of  stomach  fluid. 


NEW    DISCOVERIES    RELATING    TO    DIGESTION. 

z. — This  is  the  coefficient  of  absorption.  It  indicates 
the  quantity  of  fluid  found,  or  its  approach  to  the  normal 
amount.  An  excess  of  fluid  indicates  slow  absorption. 

m. — This  coefficient  indicates  the  degree  of  activity 
of  the  stomach  in  producing  hydrochloric  acid,  one  of 
the  most  important  constituents  of  the  gastric  juice. 

The  above  data  in  relation  to  the  stomach  fluid  ob- 
tained after  a  test  meal  have  been  determined  in  the 
Laboratory  of  the  Battle  Creek  Sanitarium,  under  the 
author's  supervision,  in  more  than  five  thousand  cases, 
each  one  requiring  more  than  fifty  different  accurately 
executed  chemical  processes. 

It  is  impossible  here  to  enter  into  an  elaborate  dis- 
cussion of  the  bearing  of  all  these  important  data  upon 
the  functional  disorders  of  digestion  and  the  treatment 
of  those  disorders.  The  reader  will,  however,  be  able 
to  see  at  a  glance  that  accurate  determinations  of  this 
kind  must  render  possible  a  more  exact  adaptation  of 
remedies  and  diet  to  individual  cases  than  is  possible 
without  such  definite  and  precise  information. 

Twenty  years  ago,  when  the  writer  was  starting  out 
in  the  medical  profession,  one  of  the  greatest  difficulties 
and  embarrassments  which  he  encountered,  was  the 
lack  of  definite  information  respecting  the  disorders  of 
digestion  and  the  adaptation  of  remedies  to  their  relief. 
Prescriptions,  diet,  treatment,  and  regimen  were  almost 
altogether  matters  of  guess-work  or  intuition  ;  and,  in 
many  cases,  the  only  way  of  finding  out  whether  the 
patient  required  one  dietary  or  another,  was  to  experi- 
ment upon  him.  A  recognition  of  this  fact  caused  an 
eminent  New  York  physician  to  declare  that  every  dose 
of  medicine  was  a  blind  experiment  upon  the  vitality  of 


142  THE    STOMACH. 

the  patient.'  A  new  case  of  chronic  dyspepsia  was 
always  encountered  with  dread,  on  account  of  the  tedious 
experimental  process,  painful  alike  to  both  physician 
and  patient,  which  must  be  gone  through  in  the  dis- 
covery of  just  the  dietary  and  the  treatment  best  adapted 
to  the  case.  By  means  of  the  present  method,  however, 
it  is  possible  to  obtain  such  accurate  information  that 
treatment  and  a  dietetic  prescription  may  be  made  with 
full  confidence  that  the  patient  will  be  afforded  definite 
and  prompt  relief. 

One  of  the  most  important  advantages  gained  by 
this  precise  method  of  analysis  is  the  possibility  of 
making  an  exact  and  definite  classification  of  all  the 
functional  disorders  of  digestion.  In  relation  to  this 
new  classification,  it  may  be  said  briefly  that,  considered 
in  relation  to  the  amount  of  work  done,  there  are  four 
general  classes  of  indigestion, —  hyperpepsia,  in  which 
there  is  excessive  stomach  work  ;  hypopepsia,  in  which 
there  is  deficiency  of  stomach  work ;  apept'ia,  in 
which  there  is  no  digestive  activity  whatever ;  and 
simple  dyspepsi^  in  which  the  amount  of  work  done 
by  the  stomach  is  normal,  the  change  in  the  stomach 
work  being  qualitative  rather  than  quantitative.  By 
these  studies  I  have  been  enabled  to  subdivide  these 
several  classes  as  follows  :  — 

Hyperpepsia,  into  three  principal  classes  and  twelve 
subclasses. 

Hypopepsia,  into  two  principal  classes  and  eight 
subclasses. 

Apepsia,  into  two  subclasses. 

Simple  dyspepsia,  into  four  subclasses. 


NEW    DISCOVERIES    RELATING    TO    DIGESTION.  143 

This  makes  twenty-six  different  varieties  of  indiges- 
tion, each  with  its  individual  characteristics. 

In  the  results  of  the  study  of  over  five  thousand 
analyses  made  with  painstaking  accuracy  by  the  methods 
which  I  have  very  briefly  described,  I  have  not  found  a 
single  case  which  did  not  fall  in  one  of  the  classes 
named,  and  have  found  examples  of  every  class. 

I  give,  in  the  following  pages,  an  abbreviated  out- 
line of  the  classification,  together  with  a  brief  outline 
of  the  data  determined  by  the  thorough  investigation 
of  the  work  done  by  the  stomach  which  the  modern 
advances  in  chemistry  and  bacteriology  render  it  possi- 
ble to  make. 

It  must  not,  of  course,  be  supposed  that  the  treat- 
ment of  disorders  of  digestion  can  be  made,  even  by 
these  exact  methods,  in  any  way  mechanical  or  routine, 
since  every  individual  case  presents  peculiarities  which 
must  be  taken  into  consideration.  The  withdrawal  of 
the  contents  of  the  stomach  in  the  midst  of  the  proc- 
ess of  digestion,  enables  us  to  surprise  the  stomach  at 
its  work,  and  thus  to  detect  special  faults,  such  as  ex- 
cess or  deficiency  of  activity,  abnormal  fermentations 
through  the  development  of  germs  in  the  stomach, 
etc. ,  and  thus  makes  clear  much  which  has  heretofore 
been  a  mystery,  or  a  matter  of  pure  speculation  in 
relation  to  the  disorders  of  digestion.  Nevertheless, 
the  size,  shape,  and  location  of  the  stomach  in  relation 
to  normal  conditions,  and  many  other  details,  must  be 
taken  into  consideration  in  formulating  a  prescription. 
10 


144  THE    STOMACH. 


CLASSIFICATION  OF  FUNCTIONAL  DISORDERS  OF  THE  STOMACH 

IN   RELATION   TO    PROTEID    DIGESTION, 

Based  upon  a  Quantitative  Chemical  Examination  of  the  Stomach  Fluid 
Obtained  after  a  Test  Meal,  in  over  5,ooo  Cases. 


The  symbols  under  each  head  indicate  the  characteristics  of 
each  individual  form  of  quantitative  disturbance  to  which  the 
stomach  is  subject. 

HYPERPEPSIA.    A'  +. 

=      -  Without  ferm'n't'n  (x  0). 
-  piCal  ''' 


Bclncbd2   a-         Without  ferm'n't'n  (x  0). 

chlorin  in  excew.)  }  2.    With  (X  -}-). 

1    a=  (  1.  Without  ferm'n't'n  (x  0). 

2.  a-  \  l-  wjthout  ferm'n't'n  (x  0).' 
j  2.   With  (x  -J-). 

1  a=\}-  Without  ferm'n't'n  (a;  0). 

2  a_  j  l'  Without  ferm'n't'n  5  0).' 
chiorin  tc].)  ]2.  With  (x-f). 

HYPOPEPSIA.    A—. 

-  Without  ferm'n't'n  (*  0). 


_  j  1.  Without  ferm'n't'n  (x  0). 
.  j1'"-  {  2.  With  "          (x+). 

f  nci  w)'  '  /  2   a-U-  Without  ferm'n't'n  (x  0). 


2.  With  (x  +). 

APEPSIA.    A  o  or  —  a  o  or  —  H  o. 

1.  Without  ferm'n't'n  (x  0). 

2.  With  (x+). 

SIMPLE  DYSPEPSIA.    A  =. 

_  j  1.  Without  ferm'n't'n  (x  0). 
~\2.  With  "          (x+). 

1.  Without  ferm'n't'n  (x  0). 

2.  With  "          (x+). 


NEW    DISCOVERIES    RELATING    TO    DIGESTION.         145 

RESULTS  OF  QUALITATIVE  AND  QUANTITATIVE  DETERMINA- 
TIONS RELATING  TO  SALIVARY  DIGESTION  AND  THE  STOM- 
ACH FLUID  OBTAINED  AFTER  A  TEST  MEAL. 

( The  results  given  below  represent  the  actual  facts  found  in  a  case 
of  hyperpepsia  as  taken  from  the  author's  office  file.) 


Case  No... 5284.. 

M/ss  B Date Aug.  25, 189.5. 

Test  Meal. —  Regular  Test  Breakfast 


Time  of  Digestion / h 13 m. 

PHYSICAL  AND  MICROSCOPICAL  CHARACTERS. 

Physical.  Normal. 

Amount.  .55.  .c.c.  (40c.c.);  Disintegration. .-(-..;  Color. ./».. 

Residue.  .25 .  .grms.  (20  grms.) ;  Mucus  .  . .  .0 ;  Odor  .  .n. . 

Microscopical. —  Blood ;  Pus ;  Misc ;  Bacteria: 

No per  c.  c.;  Character 

COLORIMETRIC  AND  OTHER  QUALITATIVE  REACTIONS. 

DIGESTIVE  AGENTS. 

Free  HC1  Congo  Red. .-(-..  Resorcine. .  +  . .  Dried  Residue,  .-f. . 
Pepsin Rennet  Ferment. +  . .  Rennet  Zymogen.+. .  Bile.0. . 

DIGESTIVE   PRODUCTS. 

Proteids. —  Syntonin.  ...-{-••  Propeptone. ..-(-..   Peptone. ..-}-.. 

Albuminoids. .-)-. . 
Starch  (Lugol's  Sol.),  Blue,  Violet,  Brown,  Yellow,  Colorless. 


FERMENTATION  PRODUCTS. 

Lactic  Acid. . .  .-f-. ...  /  Acetic. . 

Alcohol Volatile  Acids •]  Butyric 

Misc (  Formic  . 

QUANTITATIVE  CHEMICAL  DETERMINATIONS. 

DIGESTION   OF   ALBUMEN. 

Total  acidity,  ( A  ) 314. .  .grms.  (.180-.200  grms.)  A\ 

Calculated  acidity,  (A1)**  .362...     "  "       A' 

Total  chlorin,  (T) 350..     "  (.300-.330     "    ) 

FreeHCl,  (H) 042...     "  (.025-.050      "    }H 

Combined  chlorin,  (C). ..  .320. ..     "  (.155-.180     "    )  C 

Fixed  chlorids,  (F) 032. . .    "  (.100-.110     "    )  "" 


146  THE    STOMACH. 

DIGESTION  OF  STARCH. 

Saliva,  am't  in  5  m.. 11.. grms.  (1  c.  c.)  con  verted.  1  grm.  in.  .13.  .m. 

Maltose,  (M) 1.424 grms. 

Dextrin  and  Soluble  Starch  (D) 5.916. ...     " 

Fatty  Acids  (from  fermentation)  (L) 005 " 

(Lactic  acid.  ..006.  .grms.     Volatile  acids grms) 

COEFFICIENTS  OF  DIGESTIVE  WORK,  ft 

Gastric     |  Proteids  (a) 83 Fermentation  (x) .  6 

Digestion  i  Starch  (l>) 24. ...     Solution  (y) 1.48  . . 

Salivary  Activity  (c) 42 Absorption  (z) 42  . . 

Coefficient  of  Chlorin  Liberation  (m) 1.38  . . 

Proteid  Digestion  and  Acid  Fermentation  (a  and  a;) 1.03  . . 


Diagnosis. — Hyperpepsia  with   fermentation  (2-2-2)   and   im- 
perfect digestion  of  starch. 

*The  acidity  (A  and  AO  and  the  quantities  of  chlorin  in  the  differ- 
ent forms  of  (T),  (H),  (C),  and  (F),  are  expressed  as  HC1.  The  values  given 
relate  to  100  c.c.  of  stomach  fluid.  The  amount  of  fatty  acids,  chiefly 
lactic  (L),  is  expressed  in  grams  of  HC1,  which  should  be  multiplied  by  2 
to  indicate  the  actual  amount  of  lactic  acid  present.  The  amount  of  mal- 
tose (M),  as  well  as  that  of  soluble  starch  and  dextrin  (D),  is  expressed  in 
grams  of  equivalent  dextrose. 

tBy  noting  the  sign  following  the  symbols  in  this  column  and  co- 
efficients (a)  and  (x),  and  referring  to  the  classification,  the  diagnosis  of 
any  case  in  relation  to  proteid  digestion  and  fermentation  may  be  easily 
made.  By  transferring  the  figures  to  the  blank  for  "  Graphic  Represen- 
tation," the  indications  will  be  seen  at  once,  the  analysis  thus  furnishing 
a.  basis  for  rational  treatment  and  the  proper  dietary. 

**  The  calculated  acidity  (AO  is  determined  by  the  following  formula : 
C  +  H  —  L  =  A'. 

ttThe  normal  amount  of  work  is,  in  the  case  of  each  coefficient,  rep- 
resented by  1.00.  The  figures  given  usually  represent  the  percentage  of 
deviation  from  normal.  The  coefficient  of  fermentation  represents  the 
number  of  milligramsof  lactic  acid  or  combined  fatty  acids  found  in  each 
100  c.c.  of  stomach  fluid  (expressed  in  equivalent  HC1). 

The  sign  -f  indicates  presence  in  normal  quantity;  -\--\-  in 
excessive  quantity;  —  in  deficient  quantity;  0  (zero)  wholly 
absent. 

As  regards  the  relative  frequency  of  the  different 
classes,  simple  dyspepsia  is  the  most  common  of  all. 
Apepsia  is  quite  rare.  I  have  met  less  than  fifty  cases 


NEW   DISCO VEEIES   RELATING   TO    DIGESTION.          147 

in  more  than  five  thousand,  or  a  little  less  than  one 
per  cent.  Hypopepsia  and  hyperpepsia  are  about 
equally  frequent. 

As  regards  recognition  of  these  various  classes  hy 
symptoms  alone,  I  am  sorry  to  be  obliged  to  say  that 
it  is  impossible.  A  test  breakfast  and  a  careful  ex- 
amination such  as  I  have  described  is  absolutely 
essential  to  a  precise  diagnosis  of  the  functional  dis- 
orders of  digestion.  One  who  has  studied  a  large  num- 
ber of  cases  by  the  method  described,  may,  by  a  careful 
study  of  the  symptoms,  sometimes  form  an  approximately 
correct  judgment  in  respect  to  the  nature  of  the  case 
in  hand  without  making  a  chemical  examination  ;  but 
positive  information  can  be  obtained  by  no  other 
method  than  by  exact  chemical  analysis.  A  few  points 
relating  to  symptoms  are  worthy  of  mention,  as  fol- 
lows :  — 

In  hyperpepsia  there  is  an  excessive  secretion  of 
gastric  juice,  in  connection  with  which  there  is  usually 
a  good  appetite,  but  an  excessive  irritability  of  the 
stomach,  as  is  shown  by  the  tenderness  elicited  by 
pressure  at  the  pit  of  the  stomach  or  just  at  the  lower 
end  of  the  sternum.  Other  symptoms  due  to  excessive 
irritation  of  the  gastric  mucous  membrane  are  also 
more  common  than  in  simple  dyspepsia,  hypopepsia, 
or  apepsia.  Acidity  not  due  to  fermentation  is  com- 
monly present  in  extreme  cases  of  hyperpepsia.  This 
form  of  acidity  develops  soon  after  the  taking  of  a 
meal,  gradually  increasing  until  the  food  is  expelled 
from  the  stomach  into  the  intestines  three  or  four 
hours  after  eating,  or  until  the  acid  contents  of  the 
stomach  are  washed  out  with  a  stomach-tube,  diluted 


148  THE    STOMACH. 

by  the  drinking  of  water  or  some  other  fluid,  or  some- 
what modified  by  the  taking  of  more  food,  or  neutralized 
by  soda,  carbonate  of  magnesia,  or  some  other  alkali. 
Patients  suffering  from  hyperpepsia  are  often  fleshy 
and  florid,  although  not  infrequently  they  are  quite 
thin  in  flesh. 

In  hypopepsia  there  is  often  a  loss  of  appetite, 
general  feebleness,  pallor,  and  more  or  less  pronounced 
symptoms  of  indigestion,  with  anemia,  or  an  impover- 
ished condition  of  the  blood. 

In  apepsia  the  symptoms  of  hypopepsia  are  very 
much  more  pronounced. 

In  simple  dyspepsia  the  principal  symptoms  may 
be  simply  weight  at  the  stomach,  and  evidences  of 
fermentation. 

In  case  of  fermentation,  whatever  other  symptoms 
may  be  present,  the  bacteriological  examination  shows 
germs  of  some  sort  present  in  great  numbers.  In 
one  case  investigated  in  the  Laboratory  of  Hygiene 
connected  with  the  Battle  Creek  Sanitarium  (Mich., 
U.  S.  A.),  the  stomach  fluid  was  found  to  contain  for 
each  ounce,  more  than  16,437,300  yeast  cells.  Other 
germs  were  entirely  absent.  By  the  aid  of  this  investi- 
gation it  has  often  been  possible  to  make  an  immediate 
and  successful  application  of  appropriate  remedies, 
which,  without  this  method  of  learning  the  exact  con- 
ditions present,  could  only  have  been  reached  by  a 
long  and  perhaps  disappointing  experimental  effort. 


SYMPTOMS  OF  DYSPEPSIA. 


As  nearly  every  disease  may  include  among  its 
symptoms  some  disorder  of  digestion,  so  dyspepsia  may 
include  in  its  symptoms  some  of  those  of  nearly  every 
disease  that  could  be  named.  This  is  readily  under- 
stood when  we  consider  the  fact  that  impairment  of 
digestion  interferes  with  the  nutrition  of  every  organ 
of  the  body.  Every  part  suffers,  and  of  course  the 
suffering  organs  express  themselves  in  the  various 
symptoms  by  which  they  manifest  diseased  or  dis- 
ordered functions.  The  particular  features  manifested 
in  any  given  case  will  differ  with  individual  peculiari- 
ties of  constitution  or  temperament,  which  give  promi- 
nence to  some  particular  set  of  symptoms  which  may 
or  may  not  refer  to  the  stomach.  As  a  usual  thing, 
however,  there  are  certain  symptoms  which  refer  di- 
rectly to  the  stomach,  and  which  are  generally  under- 
stood as  indicating  disordered  digestion.  The  intensity 
of  the  symptoms  manifested  varies  from  the  slight  un- 
easiness and  sense  of  weight  or  fulness  occasioned  by 
a  small  excess  of  eating,  to  the  most  distressing  and 
painful  condition  of  the  more  aggravated  forms  of  the 
disorder. 

When  possible  to  do  so,  the  treatment  of  every 
case  of  disordered  digestion  should  be  preceded  by  a 
careful  examination  of  the  stomach  fluid,  which  gives 
information  obtainable  in  no  other  way,  and  which  can 

[149] 


150  THE    STOMACH. 

be  relied  upon  as  exact.  It  is  not  always  necessary 
that  the  patient  should  visit  a  laboratory  in  order 
that  an  examination  be  made.  Most  modern  phy- 
sicians are  provided  with  suitable  stomach-tubes,  and 
can  administer  the  test  breakfast  and  remove  the 
stomach  fluid  at  the  proper  time,  place  it  in  a  clean 
bottle,  carefully  seal  and  pack  the  same,  and  send  it 
by  express  to  a  laboratory  in  which  such  examinations 
are  made.  Stomach  fluids  usually  keep  without  ma- 
terial change  for  some  little  time.  (For  directions  for 
test  meal,  see  page  134.) 

As  this  work  is  especially  intended,  however,  for 
persons  who  are  so  situated  that  they  cannot  avail 
themselves  of  skilled  medical  advice,  and  since  the 
home  treatment  of  this  disease  must  be  largely  sympto- 
matic, we  present  a  simple  classification  based  upon 
symptoms,  and  a  detailed  account  of  the  principal 
symptoms  of  dyspepsia,  together  with  the  best  methods 
obtainable  at  home  for  the  cure  of  the  disease,, 

Classification  of  Indigestions. —  Dyspepsia 
may  be  classified,  first,  as  acute  and  chronic.  One  of 
the  most  important  differences  between  an  acute  and  a 
chronic  case  of  indigestion  is  that  in  acute  dyspepsia 
recovery  will  occur  in  time,  usually  in  a  very  short 
period,  by  the  unaided  efforts  of  nature  ;  while  a  chronic 
case  of  the  disease  continues  from  bad  to  worse,  or 
without  material  improvement,  indefinitely. 

Most  cases  of  acute  dyspepsia  are  the  result  of 
excess  in  eating,  taking  food  at  an  unseasonable  hour, 
the  partaking  of  unwholesome  and  indigestible  sub- 
stances, or  the  accidental  swallowing  of  some  highly 
irritating  substance,  as  poisoned  or  decayed  food,  or 


SYMPTOMS    OF    DYSPEPSIA.  151 

some  similar  irritant.  The  majority  of  these  cases 
recover  spontaneously,  and  so  quickly  that  they  scarcely 
need  further  attention  in  this  connection. 

Chronic  dyspepsia  is  generally  much  less  active  in 
its  symptoms  than  is  the  acute  form  of  the  disease.  It 
usually  begins  slowly,  making  its  advances  insidiously, 
and  thus  for  a  long  time  eluding  observation,  in  many 
instances  until  well  established.  This  is  one  reason 
why  the  diagnosis  of  the  disease  is  often  obscure. 
Very  frequently  it  is  overlooked  for  years,  being  mis- 
taken for  some  other  disease  through  the  special  promi- 
nence of  symptoms  elsewhere  than  in  the  stomach. 

Basing  the  classification  of  chronic  dyspepsia  upon 
the  most  prominent  symptoms  observed  in  different 
cases  of  the  disease,  by  far  the  greater  proportion  may 
be  included  in  the  following  five  classes  ;  viz.,  simple, 
acid,  septic  or  bilious,  painful,  and  nervous  dyspepsia. 

Each  of  the  classes  named  has  its  characteristic 
symptoms,  though  any  given  case  may  combine  the 
symptoms  of  one  or  of  all  the  different  classes.  After 
a  brief  consideration  of  the  most  important  symptoms 
relating  to  the  stomach  which  appear  in  different  phases 
of  the  disease,  we  will  consider  the  special  symptoms, 
or  groups  of  symptoms,  which  characterize  the  differ- 
ent classes  of  dyspepsia  mentioned. 

Principal  Symptoms  of  Indigestion. — The 
different  symptoms  observed  in  the  disorders  of  diges- 
tion arise  from  — 

1.  Disturbance  or  irritation   of   the  nerves  of  the 
stomach. 

2.  Disturbance  of  the  muscular  apparatus,  or  motor 
functions,  of  the  stomach. 


152  TI1E    STOMACH. 

3.  Disturbance    of    the     secreting,    or   glandular, 
functions  of  the  stomach. 

4.  Change  in  the  size  and  location  of  the  stomach, 
as  in  dilatation  and  prolapse. 

In  addition  to  these,  there  are  also  physical  symp- 
toms relating  to  the  tongue  ;  symptoms  pertaining  to 
the  evacuation  of  the  stomach  and  bowels,  vomited 
matters,  and  stools  ;  symptoms  which  pertain  to  the 
rectum  ;  and  various  general  and  remote  symptoms 
which  are  the  outgrowth  of  the  disorders  of  digestion. 
A  brief  enumeration  of  the  most  important  of  these 
symptoms  may  be  found  of  practical  interest.  They 
are  presented  here  in  the  order  in  which  the  writer 
commonly  notes  them  in  the  examination  of  a  patient. 

Symptoms  Pertaining  to  the  Mouth. —  1.  Morbid 
sensations  —  stinging,  burning,  loss  of  taste  and  mor- 
bid tastes,  such  as  metallic,  acid,  sweet,  or  peppery  sen- 
sations ;  2.  Secretion  —  viscid,  scanty,  or  in  excess; 
3.  Mucous  membrane  —  small  ulcers,  red  points  ;  4. 
Breath  —  sour,  fetid,  fecal ;  5.  Coated  tongue. 

Symptoms  Pertaining  to  the  Throat. —  Excessive 
thirst,  dryness,  irritation,  cough,  choking. 

Symptoms  Pertaining  to  the  Esophagus. — Symptoms 
of  burning,  constriction,  or  a  feeling  of  a  ball  or  lump 
in  the  throat. 

Symptoms  Pertaining  to  the  Stomach. —  Symptoms 
arising  from  disturbance  of  sensation  — distention,  con- 
striction, heaviness,  burning,  coldness,  sensation  of  ful- 
ness, beating;  abnormal  hunger, —  constant,  sudden, 
and  uncontrollable,  frequently  requiring  food  between 
meals  ;  appetite  excessive,  diminished,  variable,  de- 
praved, absent,  but  returning  after  taking  a  little  food, 


SYMPTOMS    OF    DYSPEPSIA.  153 

increasing  with  meal,  insatiable,  craving  for  special 
foods,  disgust  for  certain  foods  ;  nausea  ;  pain. 

Disturbances  of  the  Motor  Functions.  —  Regurgita- 
tion  of  food,  rumination  or  merycism,  eructations  of 
gas,  vomiting  of  fluid,  food,  blood,  pus,  bile,  or  mucus 
(either  with  or  without  nausea) ;  burning,  dull,  or  sharp 
pain  ;  faintness  ;  pain  on  eating. 

The  Discharges. —  Yomit, —  blood,  pus,  bile,  curd, 
bitter,  sour,  odor  of  decay;  stools, —  hard,  soft,  or 
balls,  ragged,  acid,  very  foul,  black,  clay-colored, 
watery,  oily,  mixed  with  mucus,  bloody ;  parasitic 
worms  ;  constipation,  diarrhea. 

Symptoms  Pertaining  to  the  Rectum,.  —  Painful 
stools,  burning  pain  after  stool,  loss  of  desire  to  evac- 
uate the  bowels,  anal  itching. 

General  Nervous  Symptoms. —  Nervousness,  morbid 
fears,  depression,  loss  of  memory,  lack  of  energy, 
inability  to  concentrate  the  mind,  mental  confu- 
sion, dulness  ;  disturbance  of  speech,  as  stammering  ; 
fidgets,  irritability,  insomnia,  loss  of  self-control  ; 
drowsiness  constantly,  or  after  meals  ;  headache  at  the 
back,  front,  top,  or  side  of  the  head,  affecting  one  or 
both  eyes,  constant,  periodical,  or  occasional  ;  sensation 
of  heaviness,  constriction,  or  discomfort  in  the  head,  legs, 
arms,  or  other  parts  of  the  body  ;  sensation  of  abnormal 
size  in  arms,  head,  or  legs  ;  strange  sensations  in  the 
eyes,  as  strained  feeling,  a  feeling  as  if  bursting  from 
the  sockets  or  sunken  in  the  sockets  ;  desire  to  support 
the  back  of  the  head  ;  pain  in  the  scalp  or  in  different 
portions  of  the  spine  after  drinking  or  meals  ;  pain 
between  the  shoulders  ;  pain  in  the  lower  part  of  the 
back ;  pain  between  the  ribs  or  under  the  ribs  ;  giddi- 


154:  THE    STOMACH. 

ness,  vertigo  ;  partial  or  complete  loss  of  consciousness 
due  to  sudden  fright  or  some  strong  impression  ;  sensa- 
tion of  lightness  in  the  head  ;  disturbing  dreams  ;  sudden 
awakening  at  night  with  constriction  of  chest,  with 
difficult  breathing  or  heavy  beating  of  the  heart ;  ' '  ex- 
plosions "  in  the  head  ;  coldness  between  the  shoulders  ; 
coldness  in  hands  and  feet  or  knees  ;  sensation  of  shiv- 
ering or  burning  after  eating  ;  ringing  in  the  ears  ; 
disturbances  of  vision,  unnatural  colors  ;  disturbance  of 
smell  or  taste  ;  abnormal  sensations,  such  as  numbness, 
tingling,  burning,  etc. ;  sudden  loss  of  strength  ;  trem- 
bling and  twitching  of  muscles  ;  constant  weariness  ; 
palpitation  of  the  heart ;  irregular  sensations  of  the 
heart  ;  sensation  of  constriction  or  heaviness  about 
the  heart  ;  shortness  of  breath  ;  nervous  asthma ; 
stomach  cough  ;  hiccough  ;  involuntary  sighing  ;  exces- 
sive quantities  of  urine  of  light  color  ;  scanty  urine  ;  too 
frequent  urination  ;  whitish  or  reddish  sediment  in  the 
urine. 

Physical  /Signs. —  Physical  examination  shows  in  a 
large  proportion  of  cases  of  chronic  dyspepsia,  dilata- 
tion or  prolapse  of  the  stomach  (see  page  317  and  Plate 
IY).  This  condition  is  often  indicated  by  an  un- 
natural plashing  sound  heard  by  the  patient  in  walking 
or  other  movements,  especially  after  drinking  water, 
and  by  unnatural  prominence  of  the  lower  abdomen. 

All  the  above  symptoms  and  many  others  of  less 
importance  are  observed  as  the  result  of  disordered  di- 
gestion, although  of  course  all  the  symptoms  named 
are  not  present  in  any  single  case. 


THE  SYMPTOMATIC  TREATMENT  OF 
INDIGESTION. 


Uneasiness   at   the   Stomach. —  One  of   the 

most  common  symptoms,  and  one  which  is  frequently 
the  first  noticed  by  patients,  is  an  uneasy  sensation  in 
the  stomach,  which  is  variously  described  as  fulness, 
weight,  tightness,  oppression,  heaviness,  heat,  cold, 
pulling,  "a  load  on  the  stomach,"  drawing,  "work- 
ing," etc.  There  may  or  may  not  be  tenderness  on 
pressure  at  this  stage.  The  uneasiness  complained  of 
is  greatly  increased  by  any  excess  in  food,  and  may  be 
occasioned  by  even  an  ordinary  amount,  by  eating  too 
rapidly,  by  drinking  at  or  soon  after  meals,  or  by  eating 
articles  of  food  which  are  difficult  of  digestion,  as  warm 
bread  or  biscuit  and  butter,  pastry,  fried  food,  pickles, 
etc.  The  essential  difference  between  this  condition 
and  that  resulting  from  eating  to  excess  in  health,  is 
that  the  symptoms  described  are  produced  by  an  or- 
dinary and  proper  amount  of  food,  being  only  increased 
in  severity  by  excess  in  quantity. 

These  symptoms  are  all  due  to  an  increase  of  the 
irritability  of  the  gastric  nerves.  They  may  be  caused 
by  the  use  of  alcoholic  liquors,  tea  and  coffee,  ice-cream, 
iced  drinks,  too  frequent  eating,  and  the  use  of  condi- 
ments, as  mustard,  pepper,  pepper-sauce,  horseradish, 
Worcestershire  sauce,  and  in  some  cases  by  the  use 
<>f  raw  onions,  radishes,  and  fats. 

[155] 


156  'I' UK    STOMACH. 

Treatment. —  These  symptoms  are  generally  relieved 
by  an  aseptic  dietary  (Diet  List  No.  1).  In  extreme 
cases  the  dietary  should  be  confined  to  well-disintegrated 
foods  (Diet  List  No.  7).  In  very  obstinate  cases,  a 
liquid  diet  (Diet  List  No.  11)  or  a  milk  diet  is  indicated. 
All  foods  difficult  of  digestion  (Diet  List  No.  22)  should 
be  avoided  when  there  is  fulness,  eructations  of  gas,  or 
acidity.  All  foods  which  promote  fermentation  (Diet 
List  No.  23)  should  be  carefully  avoided.  A  fomenta- 
tion (10)  should  be  applied  over  the  stomach  and  abdo- 
men at  night,  followed  by  a  wet  girdle  (9)  to  be  worn 
during  the  night,  and  the  dry  abdominal  bandage  (4-4?) 
during  the  day,  with  nutritive  treatment  (page  331),  elec- 
tricity (65,  67,  69),  Swedish  movements  (39),  and  sub- 
carbonate  or  subnitrate  of  bismuth  (62).  In  cases  of 
prolapsed  kidney,  or  in  extreme  cases  in  which  acidity 
occurs  within  an  hour  or  two  after  eating,  especially 
when  there  is  a  suspicion  of  ulcer  of  the  stomach,  bicar- 
bonate of  soda  (64)  may  be  used  in  ten-  to  fifteen-grain 
doses  before  each  meal.  The  Natural  Abdominal  Sup- 
porter (4-5)  is  required  in  cases  in  which  relief  is  ob- 
tained by  upward  pressure  with  the  hands  applied  to  the 
lower  part  of  the  abdomen. 

Flatulence. — This  symptom  indicates  the  presence 
of  gas  in  the  stomach  or  bowels,  the  character  of  which 
varies  greatly,  sometimes  consisting  of  air  which  has 
been  swallowed  with  the  food  in  hasty  eating.  Some- 
times, also,  persons  acquire  the  habit  of  swallowing 
air,  as  do  horses,  in  which  the  habit  is  known  as 
"cribbing."  The  act  requires  quite  a  strong  effort, 
yet  it  is  sometimes  practiced  constantly  by  hysterical 
patients,  and  sometimes  also  by  dyspeptics  to  relieve 


SYMPTOMATIC    TREATMENT   OF    INDIGESTION.  157 

unpleasant  sensations  at  the  stomach.  A  small  quan- 
tity of  air  is  swallowed  in  the  act  of  gulping,  which 
usually  occurs  just  before  vomiting,  and  can  be  accom- 
plished at  will  by  most  persons. 

The  usual  cause  of  gaseous  distention  of  the  bowels, 
however,  is  the  formation  of  gas  within  the  bowels 
themselves,  by  the  fermentation  of  starch  or  sugar. 
Sometimes  this  occurs  to  an  enormous  extent,  giving 
rise  to  belching  and  eructations,  well  compared  to 
roaring  in  extreme  cases.  In  some  cases,  accom- 
panied by  hysterical  manifestations,  the  accumulation 
of  gas  will  be  almost  instantaneous.  In  these  cases 
the  air  may  be  swallowed,  or  regurgitated  from  the 
small  intestine. 

It  is  probable  that  flatulence,  or  distention  of  the 
stomach  with  gas,  is  sometimes  due  to  the  secretion 
of  gas  from  the  blood.  It  seems  to  be  rapidly  thrown 
out  in  great  quantities  in  certain  cases,  particularly 
in  nervous  disease  of  the  stomach. 

When  caused  by  fermentation,  the  gas  usually  con- 
sists chiefly  of  carbonic  acid,  from  the  destruction  of 
starch  and  sugar,  and  is  both  tasteless  and  odorless. 
At  other  times  it  contains  sulphureted  hydrogen  and 
other  foul  gases,  from  the  decomposition  of  the  albu- 
minous and  fatty  elements  of  the  food  through  the  ac- 
tion of  germs. 

Intestinal  flatulence,  giving  rise  to  rumbling  in  the 
bowels,  or  borborygmus,  has  the  same  causes  as  flatulence 
of  the  stomach.  The  form  of  flatulence  which  affects 
chiefly  the  small  intestine  seems  to  be  in  a  great  degree 
due  to  deficient  secretion  of  bile.  It  affects  chiefly 
weakly  persons,  those  greatly  debilitated  by  chronic 


158  THE    STOMACH. 

rheumatism,  especially,  and  more  often  women  than 
men.  It  is  frequently  a  cause  of  sleeplessness,  and  of 
unpleasant  and  erotic  dreams,  giving  rise  to  nocturnal 
losses  in  persons  whose  sexual  organs  are  in  a  weakened 
condition. 

Flatulency  of  the  colon,  or  large  intestine,  occa- 
sioning offensive  gaseous  discharges,  arises  from  the 
decomposition  of  the  retained  contents  of  the  bowel. 
It  occurs  most  frequently  as  an  accompaniment  of  con- 
stipation, and  of  a  deficiency  of  bile.  This  condition  is 
especially  noticeable  in  cases  in  which  a  mixed  or  a 
meat  diet  has  been  used,  in  consequence  of  the  decompo- 
sition of  portions  of  undigested  meat,  which  takes  place 
in  the  colon.  In  cases  of  this  kind  there  is  constant 
poisoning  of  the  system  through  the  absorption  of  sol- 
uble poisons  which  are  formed  in  connection  with  the 
offensive  gases. 

Treatment. — Temporary  relief  from  flatulence  may 
generally  be  obtained  by  sipping  a  little  very  hot  water, 
either  with  or  without  a  few  drops  of  some  volatile  sub- 
stance, as  camphor,  peppermint,  or  cinnamon.  The 
hot  water-bag  over  the  stomach  usually  gives  relief  if 
there  is  much  distention  with  the  flatulence.  Perma- 
nent relief  from  this  condition  can  be  obtained  only  by 
employing  an  aseptic  dietary  ( Diet  List  No.  1 ).  It  is 
generally  necessary  to  discard  all  articles  difficult  of 
digestion  (  Diet  List  No.  22 ),  and  those  which  are  apt 
to  promote  fermentation  (Diet List  No.  23).  In  cases 
in  which  starch  is  digested  only  with  difficulty,  farina- 
ceous foods  (Diet  List  No.  4)  must  be  avoided,  and 
a  nitrogenous  dietary  should  be  strictly  adhered  to  for 
some  time,  with  tonic  water  treatment  (page  333), 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION. 


159 


electricity  (65,  66,  68),  massage  (30,  31),  Swedish 
movements  (42),  and  daily  exercise  in  the  open  air. 
Charcoal  tablets  (47,  4-8,  49)  should  be  taken  after 
each  meal. 

Fermentation. —  Septic  and  even  putrefactive 
changes  may  take  place  within  the  body  as  well  as 
outside  of  it.  According  to  the  conclusions  arrived 


FIG.  17.— YEAST. 

at  by  careful  scientific  investigation,  the  process  of  fer- 
mentation consists  of  changes  in  organized  substances 
induced  by  germs  received  from  the  air.  There  are  va- 
rious kinds  of  germs,  which  induce  different  forms  of 
fermentation.  A  variety  of  organisms  known  as  yeast, 
excites  the  fermentation  by  means  of  which  bread  is 
raised,  beer  and  wine,  fermented,  etc.  Through  the 
H 


160  THE    STOMACH. 

action  of  yeast,  sugar  and  starch  are  first  converted  into 
carbonic  acid,  alcohol,  and  water. 

It  is  this  kind  of  fermentation  which  produces  that 
form  of  flatulence  in  which  the  stomach  is  distended 
with  a  tasteless  and  odorless  gas.  In  the  stomach, 
the  process  is  precisely  the  same  as  in  the  baker's 
dough  trough  or  the  beer  vats  of  the  brewer.  When 
digestion  is  promptly  performed,  the  food  is  digested 
and  absorbed  before  it  has  time  to  ferment;  but  when 
it  is  slow,  either  on  account  of  deficient  muscular 
action  on  the  part  of  the  stomach,  or  because  of  de- 
ficient or  defective  secretion  of  gastric  juice,  fermenta- 
tion takes  place  before  digestion  is  completed.  The 
conditions  of  the  stomach  are  then  peculiarly  favorable 
for  the  occurrence  of  fermentation. 

This  change  would  always  occur  in  the  stomach 
were  it  not  for  the  preservative  influence  of  the  gastric 
juice,  which,  when  hydrochloric  acid  is  present  in  suffi- 
cient quantity,  effectually  prevents  fermentation  by  de- 
stroying the  germs  which  enter  through  the  mouth,  or 
which  are  ordinarily  taken  in  the  food.  As  before  re- 
marked, however,  if  digestion  is  delayed  for  any  reason, 
the  germs  taken  in  from  the  air  or  with  the  food  quickly 
excite  fermentative  changes,  and  gases  and  various 
poisons  are  developed. 

Bacteriological  experiments  conducted  in  the  Lab- 
oratory of  Hygiene  of  the  Battle  Creek  Sanitarium 
(Michigan,  U.  S.  A.)  for  the  purpose  of  studying  the 
nature  and  action  of  germs  found  in  the  stomach,  have 
shown  that  the  healthy  stomach  is  capable  of  destroying 
the  germs  which  enter  it  in  the  act  of  eating,  providing 
the.  food  itself  is  sterilized  ;  that  is?  before  !>eing  eaten 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  161 

it  is  heated  to  a  temperature  sufficiently  high  to  de- 
stroy any  germs  which  it  may  contain.  This  is  found 
to  be  true,  at  least  in  the  case  of  granose,  a  thoroughly 
sterilized  food.  In  nine  stomach  fluids  obtained  after 
eating  granose,  germs  were  found  in  only  two  cases, 
and  then  very  few  in  number. 

Raised  bread  and  ordinary  biscuit  always  contain 
quantities  of  yeast  germs  in  their  interior  which  have 
not  been  exposed  to  a  sufficiently  high  temperature  to 
destroy  their  vitality.  When  taken  into  the  stomach, 
these  germs  grow  and  develop,  producing  fermentation. 
Various  yeasts,  the  spores  of  which  are  always  to  be 
found  in  flour,  and  which  give  rise  to  fermentation  in  the 
presence  of  warmth  and  moisture,  occasion  in  the  stom- 
ach the  alcoholic  fermentation  by  which  carbonic  acid 
gas  is  produced  in  abundance,  and  even  small  quanti- 
ties of  alcohol.  Other  germs  give  rise  to  acetic  acid,  or 
vinegar  fermentation,  in  which  the  alcohol  produced  by 
the  action  of  yeast  germs  is  converted  into  acetic  acid. 
Other  germs  produce  the  lactic  acid,  or  sour-milk  fermen- 
tation, and  still  others  give  rise  to  a  butyric-acid  fermen- 
tation, the  fermentative  change  which  occasions  the 
rancid  flavor  of  strong  butter  or  decomposing  fats. 

All  of  these  fermentations  may  take  place  at  the 
same  time.  While  the  healthy  stomach  is  able  to  de- 
stroy a  few  germs,  the  quantity  of  germs  introduced 
with  the  food  may  be  so  great  that  even  a  healthy 
stomach  cannot  destroy  them  all.  This  is  likely  to  be 
the  case  in  the  use  of  cheese,  meat  which  has  acquired 
a  "high"  flavor,  sauerkraut,  and  such  unnatural  foods 
as  oysters,  either  raw  or  imperfectly  cooked,  the  liquor 
of  which  swarms  with  germs,  infusoria,  and  other  small 


162  THE    STOMACH. 

creatures  such  as  abound  in  the  slime  and  ooze  of  stag- 
nant waters  along  the  seashore. 

Treatment.  —  The  treatment  is  essentially  the  same 
as  that  recommended  for  flatulence  (see  page  156). 
Special  care  must  be  taken  to  avoid  all  foods  likely  to 
promote  fermentation  (Diet  List  No.  23);  charcoal  tab- 
lets (48,  49)  should  be  taken  after  each  meal.  In  ob- 
stinate cases  it  is  necessary  to  confine  the  diet  to  the 
very  simplest  articles.  Zwieback  or  granose  eaten  dry 
will  often  be  digested  when  fluid  foods  give  great  dis- 
tress. A  diet  of  granose  and  bromose  (Diet  List  No. 
25)  will  be  found  most  efficient  in  relieving  this  condi- 
tion in  a  great  majority  of  cases. 

In  cases  which  do  not  yield  to  the  above  measures, 
lavage,  or  stomach  washing  (46),  must  be  resorted  to. 
At  first  it  may  be  necessary  to  administer  lavage  two 
or  three  times  a  week,  or  even  daily  for  a  few  days  ; 
but  if  the  diet  has  been  carefully  regulated,  the  stomach 
washing  may  be  made  more  and  more  infrequent,  until, 
at  the  end  of  three  or  four  weeks,  its  use  may  be  dis- 
pensed with  altogether.  Too  long-continued  use  of  the 
stomach- tube  is  injurious. 

Acidity. — This  symptom  may  be  due  to  the  for- 
mation of  either  acetic  or  lactic  acid  in  the  stomach  by 
means  of  germs,  as  has  already  been  explained.  The 
substances  most  likely  to  give  rise  to  acidity  are  bakers' 
bread,  milk,  sweets,  confectionery  of  all  sorts,  ice- 
cream, rich  sauces,  beer,  wine,  fluid  foods,  such  as 
soups,  and  farinaceous  foods  when  taken  with  large 
quantities  of  liquids,  particularly  cold  fluids.  In  pa- 
tients suffering  from  dilatation  of  the  stomach,  all 


SYMPTOMATIC    TREATMENT    OF   INDIGESTION.  163 

starchy  or  saccharine  foods  are  likely  to  give  rise  to  acid- 
ity by  reason  of  fermentation. 

This  condition  requires  the  same  treatment  as  has 
been  recommended  for  flatulence  and  fermentation. 
The  habit  of  relieving  acidity  by  means  of  soda,  mag- 
nesia, alkaline  mineral  waters,  etc.,  is  an  exceedingly 
injurious  one,  and  serves  to  aggravate  the  difficulty  by 
lessening  the  activity  of  the  gastric  juice.  The  only 
remedy  which  can  be  properly  used  for  relieving  acidity 
is  water.  A  copious  draft  of  warm  water  may  give  re- 
lief, either  by  producing  vomiting  or  by  diluting  the  ir- 
ritating acids  to  which  the  mucous  membrane  of  the 
stomach  is  exposed. 

Acidity  from  Hyperpepsia. — A  form  of  acid- 
ity not  due  to  fermentation  is  occasionally  encountered. 
It  is  not  due  to  the  action  of  germs  in  the  stomach,  but 
to  the  formation  of  an  excess  of  gastric  juice  or  of  gas- 
tric juice  containing  too  much  hydrochloric  acid.  This 
form  of  acidity  is  likely  to  be  accompanied  by  in- 
tense burning  at  the  pit  of  the  stomach.  Gastric  crises, 
or  attacks  of  severe  pain  in  the  stomach  soon  after  eat- 
ing, frequently  occur  in  these  cases.  Hot  liquids,  acid 
foods,  especially  fruits,  and  in  many  cases  sweet  foods, 
increase  the  acidity,  and  are  likely  to  give  rise  to  pain. 
Eructations  of  a  sour  or  bitter  liquid  are  frequent  in 
this  form  of  acidity.  There  is  not  usually  distention  of 
the  stomach  with  gas,  or  flatulence  ;  but  in  some  cases 
gas  is  formed,  not  by  fermentation,  but  by  secretion 
from  the  blood.  In  this  form  of  acidity  the  pain 
usually  begins  half  an  hour  or  an  hour  after  eating,  and 
increases  as  long  as  the  food  remains  in  the  stomach. 


164  THE    STOMACH. 

In  some  extreme  cases  of  this  class  the  secretion  of  hy- 
drochloric acid  continues  all  the  time,  even  when  the 
stomach  contains  no  food.  In  these  instances,  an  ex- 
tremely sour,  acrid  liquid  is  often  regurgitated  from  the 
stomach  before  eating  in  the  morning. 

Treatment. — This  condition  is  sometimes  an  exceed- 
ingly obstinate  one,  resisting  the  measures  of  treatment 
employed  until  both  patient  and  physician  are  thoroughly 
discouraged.  The  dietary  and  general  measures  of  treat- 
ment suggested  for  the  relief  of  uneasiness  at  the  stom- 
ach are  applicable  to  cases  in  which  acidity  from 
excessive  secretion  of  gastric  juice  is  a  prominent 
symptom.  When  these  measures  do  not  fully  relieve 
the  condition,  subcarbonate  or  subnitrate  of  bismuth 
(62)  may  be  taken  before  meals  in  twenty-grain  doses, 
and  bicarbonate  of  soda  (64)  either  just  before  or  soon 
after  eating,  or  an  hour  or  two  later,  as  may  be  required. 

Heartburn. —  A  burning  or  smarting  sensation, 
often  spoken  of  as  "heartburn,"  is  frequently  felt  at 
the  pit  of  the  stomach  or  the  lower  end  of  the  esopha- 
gus, sometimes  extending  upward,  and  often  accom- 
panied by  the  rising  into  the  mouth  of  a  small  quantity 
.of  a  very  acrid,  irritating,  pungent,  foul-smelling 
liquid.  The  latest  investigations  on  the  subject  seem 
to  show  that  this  symptom  is  due  to  the  formation  in 
the  stomach  of  butyric  or  lactic  acid,  from  the  fermen- 
tation of  some  of  the  elements  of  food.  The  formation 
of  butyric  acid  is  particularly  favored  by  the  presence 
in  the  stomach  of  fatty  substances.  It  is  this  acid 
which  gives  to  old  cheese  and  very  rancid  butter  their 
peculiar  pungency.  It  is  also  to  its  presence  that  the 
nauseating  odor  of  vomited  matters  is  due. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  165 

The  use  of  cheese,  an  article  entirely  unwholesome 
and  utterly  unfit  to  enter  a  human  stomach,  is  very 
likely  to  produce  the  sensation  of  ' '  heartburn. ' ' 

Treatment. — When  heartburn  is  habitual  or  a  con- 
stant symptom  after  eating,  lavage  (4-6)  is  required.  As 
a  rule,  however,  simple  regulation  of  the  dietary  is  suf- 
ficient to  effect  a  cure.  The  diet  should  be  aseptic  (Diet 
List  No.  1).  All  foods  difficult  of  digestion  (Diet  List 
No.  22)  and  likely  to  give  rise  to  fermentation  (Diet 
List  No.  23)  should  be  avoided.  A  dry  dietary  (Diet  List 
No.  2),  particularly  the  use  of  such  foods  as  granose 
and  zwieback  (Diet  List  No.  25),  and  nut  meal  or  nut 
butter  in  the  place  of  butter,  should  be  used.  Tea  and 
coffee  and  other  drinks  at  meals  should  be  avoided. 
Employ  the  general  measures  recommended  for  ' '  Simple 
Dyspepsia,"  for  which  see  page  245. 

Water-Brash,  or  Pyrosis. —  This  is  a  symp- 
tom which  commonly  occurs  when  the  stomach  is 
empty  of  food,  or  nearly  so  ;  often  before  breakfast. 
A  quantity  of  clear  fluid,  either  slightly  acid,  alkaline, 
or  neutral  in  taste,  is  thrown  into  the  mouth  from  the 
stomach,  varying  in  amount  from  less  than  a  mouthful 
to  half  a  pint  or  more.  It  is  usually  supposed  to  be 
caused  by  the  accumulation  of  saliva  in  the  stomach, 
which  fails  to  absorb  its  fluid  contents  on  account  of 
inactivity.  The  expulsion  of  fluid  may  be  accompanied 
by  pain,  or  may  be  quite  free  from  unpleasant  sensa- 
tions of  any  kind.  It  is  a  symptom  said  to  be  almost 
universal  among  the  Lapps  and  New  Zealanders,  and 
is  also  exceedingly  prevalent  in  Scotland,  where  it 
seems  to  be  due  to  the  use  of  insufficiently  cooked 
oatmeal. 


166  THE    STOMACH. 

Recent  observations  seem  to  show  that  the  fluid  ex- 
pelled in  water-brash  is  not  raised  from  the  stomach, 
but  comes  from  the  mouth  only,  being  due  to  a  sudden 
and  profuse  secretion  of  saliva  by  the  salivary  glands. 

This  symptom  indicates  an  irritable  condition  of  the 
sympathetic  nervous  system.  It  may  be  produced  by 
prolapse  of  the  stomach,  a  floating  kidney,  pressure  of 
waistbands,  and  similar  causes,  as  well  as  by  errors 
in  diet  ;  hence  attention  should  be  given  to  the  removal 
of  all  these  causes,  as  well  as  to  the  correction  of  the 
dietary.  The  treatment  required  is  the  same  as  that 
recommended  for  "Uneasiness  at  the  Stomach,"  (see 
page  155). 

Nausea. — This  symptom  is  a  peculiar  sensation 
referred  to  the  stomach,  which  is  not  easily  described, 
as  it  is  unlike  anything  else.  It  usually  precedes  the 
act  of  vomiting,  though  not  always,  and  frequently  ex- 
ists without  vomiting.  It  is  derived  from  the  Greek 
word  vavs,  meaning  ' '  a  ship, ' '  being  always  a  prominent 
symptom  in  sea-sickness.  Nausea  indicates  an  irritation 
of  the  nerves  of  the  stomach,  which  may  be  due  to  an 
excessive  irritability  of  the  nerves,  whereby  they  are 
unusually  excited  by  the  mere  contact  of  food  with  the 
mucous  membrane  of  the  stomach  ;  or  it  may  be  the 
result  of  the  irritation  of  the  nerves  of  the  stomach  by 
acrid  acids  or  poisonous  substances  produced  by  germs 
in  the  stomach  or  by  the  too  long  retention  of  food  ;  or 
it  may  arise  from  the  infection  of  the  stomach  by  large 
quantities  of  microbes  which  the  gastric  juice,  through 
some  defect  in  quantity  or  quality,  is  not  able  to  de- 
stroy. There  are  also  some  so-called  nervous  cases  in 
which  nausea  is  the  result  of  the  irritation  of  the  vomit- 


SYMPTOMATIC    TREATMENT    OB1    INDIGESTION.  167 

ing  centers  in  the  brain  by  poisonous  substances  circu- 
lating in  the  blood. 

Treatment. — Swallowing  a  few  bits  of  ice,  a  few 
sips  of  hot  water,  ice  over  the  stomach,  ice  about  the 
throat,  fomentations  (10,  11)  over  the  stomach,  fomen- 
tations to  the  spine,  hot  and  cold  applications  to  the 
spine  (18),  faradization  (65)  of  the  spine  and  stomach, 
gentle  kneading  of  the  stomach  (31),  subnitrate  of  bis- 
muth (62)  in  ten-  to  twenty-grain  doses, —  these  are 
simple  measures  which  are  sometimes  successful  in  re- 
lieving vomiting.  In  cases  of  nausea  in  which  there  is 
reason  to  suspect  offensive  material  in  the  stomach,  lav- 
age  (4-6)  should  be  employed,  as  the  most  efficient  means 
of  relieving  this  condition.  In  cases  in  which  the  nausea 
is  habitual,  except  in  cases  of  pregnancy,  it  is  often  ad- 
vantageous to  withhold  all  food  from  the  stomach  for  a 
day  or  two,  or  even  longer,  nutrition  being  maintained 
by  the  nutritive  enema  (Diet  List  No.  2-i).  Fasting  is  an 
excellent  remedy  for  all  conditions  of  the  stomach  in 
which  there  is  excessive  irritability.  The  general  treat- 
ment should  be  the  same  as  that  recommended  for  ' '  Un- 
easiness at  the  Stomach"  (page  155). 

Vomiting. — The  nature  of  the  act  having  been  al-» 
ready  described,  only  its  indications  need  be  noted. 
As  a  symptom  of  acute  dyspepsia,  it  is  very  com- 
mon, but  is  much  less  so  in  chronic  disorders  of 
the  digestive  organs.  When  present,  it  usually  indi- 
cates something  in  the  stomach  which  should  be  ejected, 
being  an  effort  of  nature  to  defend  the  system  from  in- 
jury. Sometimes  the  presence  of  simple  mucus  in  ex- 
cessive quantity,  as  in  gastric  catarrh,  will  give  rise  to 
vomiting.  Vomiting  also  occurs  very  frequently  in 


168  THE    STOMACH. 

connection  with  whooping-cough,  chronic  bronchitis, 
and  consumption,  being  due  to  violent  coughing.  It 
is  also  sometimes  induced,  as  is  coughing,  by  the  tick- 
ling sensation  produced  in  the  throat  by  a  relaxed  or 
elongated  palate.  Tickling  the  throat  with  the  finger 
or  a  feather  will  in  many  persons  excite  vomiting,  espe- 
cially if  there  is  the  slightest  degree  of  nausea.  Some 
persons  can  produce  the  act  of  vomiting  at  will. 

When  violent  vomiting  continues  for  a  considerable 
length  of  time,  the  vomited  matter  consists  wholly  of 
bile  and  mucus.  The  presence  of  bile  leads  many  per- 
sons to  suppose  that  bile  is  the  cause  of  the  vomiting, 
being  an  evidence  of  ' '  biliousness, ' '  and  having  pro- 
duced nausea  by  its  presence  in  the  stomach.  This  is 
usually  an  error.  The  bile  is  usually  present  in  the 
stomach  only  as  the  result  of  reverse  action,  indicated  by 
retching  or  long-continued  vomiting. 

The  writer  has,  however,  met  several  cases  in  which 
dilatation  or  prolapse  of  the  stomach  had  dragged  the 
pyloric  orifice  down  to  so  low  a  point  that  the  bile, 
which  enters  the  small  intestine  a  few  inches  below 
the  lower  orifice  of  the  stomach,  was  led  by  gravity  to 
-  flow  into  the  stomach,  instead  of  flowing  in  the  oppo- 
site direction,  as  in  health.  In  sucn  cases  bile  is  often 
found  in  the  stomach  when,  the  organ  is  otherwise 
empty,  and  if  not  expelled  by  vomiting,  gives  rise  to 
constant  nausea  ;  by  nutralizing  the  gastric  juice,  it  se- 
riously interferes  with  stomach  digestion.  Such  cases 
require  replacement  of  the  stomach  and  support  of  the 
organ  in  position  by  means  of  the  abdominal  supporter 
(45). 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  169 

The  violent  efforts  made  in  vomiting  sometimes  ex- 
tend to  the  duodenum,  where  the  bile  exists  naturally, 
causing  it  to  be  thrown  upward  into  the  stomach,  whence 
it  is  expelled  by  vomiting.  The  first  portions  of  bile 
vomited  usually  have  a  yellowish  color,  due  to  the  fact 
that  the  alkaline  bile  is  neutralized  by  the  acid  contents 
of  the  stomach.  Afterward,  when  the  bile  becomes  more 
than  sufficient  to  neutralize  the  acid  contents  and  secre- 
tions of  the  stomach,  its  natural  greenish  color  appears. 

Severe,  protracted,  and  painful  vomiting  is  a  com- 
mon symptom  of  organic  disease  of  the  stomach,  as  in 
cancer,  ulcer,  dilatation,  contraction,  or  some  other 
structural  change. 

Treatment.  —  The  measures  suggested  for  the  relief 
of  nausea  are  also  sometimes  successful  in  the  treatment 
of  vomiting.  However,  it  is  not  infrequently  the  case 
that  vomiting  continues  in  spite  of  the  means  men- 
tioned. In  such  cases,  lavage  (4:6),  or  washing  of  the 
stomach,  is  the  most  important  measure  which  can  be 
employed,  and  it  almost  invariably  succeeds,  although 
not  infrequently  the  passage  of  the  tube  must  be  re- 
peated several  times  before  the  stomach  becomes  quiet. 
Surprisingly  large  quantities  of  fluid  are  sometimes  re- 
moved in  cases  of  this  sort,  especially  in  those  com- 
monly called  ' '  green  vomiting. ' '  In  these  cases  there 
is  regurgitation  of  bile  and  other  fluids  from  the  intes- 
tine into  the  stomach. 

Cases  are  occasionally  encountered  in  which  vomit- 
ing seems  to  'be  purely  nervous  in  character.  These 
are  sometimes  best  relieved  by  the  introduction  of  a 
small  quantity  of  food  into  the  stomach. 


170  THE    STOMACH. 

There  are  still  other  cases  in  which  vomiting  seems 
to  be  purely  hysterical  in  character,  and  which  can  be 
controlled  by  commanding  the  patient  in  a  very  positive 
manner  to  •  cease  vomiting.  The  writer  has  cured  a 
number  of  cases  in  this  way.  One  young  woman  who 
had  not  retained  a  single  meal  for  more  than  three 
years,  ceased  vomiting  when  convinced  that  she  must 
do  so  or  abstain  from  eating.  I  said  to  this  young 
woman  that  I  could  not  allow  so  much  good  food  to  be 
wasted,  and  that  if  she  insisted  upon  vomiting  every- 
thing she  ate,  she  must  cease  eating.  This  she  did  for 
a  short  time,  but  was  finally  glad  to  come  to  terms,  and 
agreed  to  vomit  no  more,  which  promise  she  kept  in  a 
very  satisfactory  manner. 

Treatment. —  Fasting,  and  the  dietetic  and  other 
measures  recommended  for  "Nausea"  (page  166)  and 
"Uneasiness  at  the  Stomach  "  (page  155)  should  be  em- 
ployed in  addition  to  the  measures  above  suggested. 
The  patient  should  rest  in  a  horizontal  position  one  or 
two  hours  after  eating. 

Regurgitation — Rumination,  or  Merycism. 
—  Rumination  is  an  act  by  which  the  food  is  returned 
to  the  mouth  from  the  stomach  by  a  reversal  of  the  act 
by  which  food  is  swallowed,  and  without  the  violent 
efforts  attending  vomiting.  In  some  animals,  as  the 
ox,  sheep,  goat,  and  others  of 'the  same  species,  all  the 
food  is  returned  to  the  mouth  in  this  way,  being  re- 
chewed.  In  man,  regurgitation  does  not  occur  in 
health,  being  caused  by  an  irritable  state  of  the  mucous 
membrane  of  the  stomach,  which  excites  contraction  in 
the  organ,  and  forces  the  food  upward.  Sometimes 
the  act  becomes  more  or  less  voluntary  ;  but  more 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  171 

often  it  is  occasioned  by  a  morbid  condition  of  the 
stomach,  and  cannot  be  readily  controlled  by  any  effort 
of  the  will. 

The  ease  with  which  some  persons  voluntarily  re- 
gurgitate substances  which  have  been  swallowed  is  very 
curious.  A  woman  who  ruminated  regularly,  amused 
her  friends  and  the  public  by  swallowing  two  live  gold 
fish,  each  about  two  and  one-half  inches  long,  regurgi- 
tating them  alive  twenty  minutes  afterward. 

Regurgitation  and  rumination  are  perhaps  only  dif- 
ferent degrees  of  a  morbid  condition.  In  regurgita- 
tion  there  is  usually  simply  a  return  of  a  small  quantity 
of  liquid  to  the  mouth.  The  patient  complains  of  spit- 
ting up  or  tasting  his  food  for  some  time  after  eating. 
In  rumination  proper,  only  the  more  solid  portions  of 
the  food  are  returned  to  the  mouth.  In  most  cases  of 
this  kind  the  food  is  re-chewed  and  swallowed.  Some 
patients  who  ruminate  profess  to  experience  a  peculiar 
pleasure  in  re-chewing  and  regurgitating  food.  The 
old  idea  that  rumination  indicates  some  relation  to 
ruminating  animals,  such  as  the  sheep  or  cow,  is  of 
course  without  any  foundation.  It  is  a  morbid  condi- 
tion, the  exact  nature  of  which  is  not  well  understood. 

Treatment. — The  food  should  consist  of  such  sub- 
stances as  will  be  quickly  dissolved  in  the  stomach  (Diet 
List  No.  7).  In  severe  cases,  a  liquid  diet  (Diet  List 
No.  11)  should  be  employed.  Granose,  bromose,  and 
kumyss  (Diet  List  No.  25)  have  been  found  especially 
helpful  in  extreme  cases.  The  diet  recommended  for 
"  Simple  Dyspepsia "  (page  245)  should  be  employed. 

Gripes,  or  Colic. —  This  symptom,  sometimes 
called  "belly-ache,"  is  caused  by  irregular  muscular 


172  THE    STOMACH. 

contraction,  or  spasm,  of  the  small  intestine.  The  ex- 
citing cause  may  be  distention  with  gas,  or  the  presence 
of  irritating  matters  in  the  bowels.  It  is  very  common 
in  patients  subject  to  constipation. 

Colic  pains  are  sometimes  caused  by  the  introduc- 
tion of  air  into  the  colon  in  the  administration  of  the 
water  enema.  In  using  the  bulb  syringe,  this  is  quite 
likely  to  occur,  but  it  cannot  take  place  to  any  extent  in 
the  use  of  the  fountain  syringe. 

Treatment. — Fomentation  (10, 11),  hot  enema  (22), 
drinking  one  or  two  glasses  of  hot  water  either  with  or 
without  the  addition  of  a  few  drops  of  peppermint  es- 
sence or  camphor,  with  a  dry  or  aseptic  dietary  (Diet 
Lists  Nos.  1,  2)  constitute  the  treatment  for  this  disor- 
der. In  cases  in  which  starch  cannot  be  digested,  a 
nitrogenous  diet  (Diet  List  No.  3)  should  be  adopted, 
and  all  foods  avoided  which  are  difficult  of  digestion  and 
liable  to  promote  fermentation  (Diet  Lists  Nos.  22,  23). 
The  general  treatment  recommended  elsewhere  for  simple 
dyspepsia  or  slow  digestion  should  be  employed. 

Weight  —  Constriction  —  Tightness,  etc.— 
A  symptom  very  often  complained  of  by  patients 
who  may  or  may  not  have  acidity,  heartburn,  water- 
brash,  and  other  local  symptoms,  is  sometimes  referred 
to  as  "a  constriction,"  "a  tightness,"  or  "oppres- 
sion," and  is  generally  referred  to  a  point  a  little  to 
the  left  of  the  median  line,  just  beneath  the  lower 
border  of  the  ribs.  It  indicates  a '  catarrhal  condition 
of  the  membrane  of  the  stomach.  The  sense  of  fulness 
which  it  often  occasions  after  eating  is  deceptive, 
being  quite  as  great  in  many  cases  when  the  stomach 
is  empty,  or  when  only  a  small  quantity  of  solid  food 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  173 

or  liquid  has  been  taken.  Persons  suffering  thus  are 
usually  very  despondent,  and  it  may  be  this  fact  that 
has  given  rise  to  the  term  hypochondria,  which  literally 
has  reference  to  the  region  in  which  the  sensation  de- 
scribed is  felt.  It  often  accompanies  spermatorrhea  and 
other  forms  of  sexual  weakness. 

The  ' '  sinking  sensation  ' '  at  the  stomach,  of  which 
many  patients  complain,  though  not  identical  with,  is 
allied  to,  the  sensation  of  weight  described. 

The  sensations  of  weight,  constriction,  tightness, 
pulling,  and  others  similar,  when  not  the  result  of  an 
excessive  meal,  are  due  to  an  abnormal  sensibility  of 
the  nerves  of  the  stomach.  These  sensations  are  most 
likely  to  be  present  in  cases  in  which  the  stomach  is 
prolapsed  or  dilated,  and  are  due  to  a  strain  upon  the 
branches  of  the  sympathetic  nerve  which  enters  the 
stomach  from  the  solar  plexus. 

Treatment. — The  same  general  treatment  should 
be  employed  as  is  recommended  for  ' '  Uneasiness  at  the 
Stomach"  (page  155.)  The  abdominal  supporter  is  us- 
ually required  (45). 

Pain. —  As  a  symptom  of  dyspepsia,  pain  may 
appear  in  the  region  of  the  stomach,  or  it  may  be 
referred  to  the  spine,  the  chest,  beneath  the  shoulder- 
blade  or  between  the  shoulders,  or,  in  fact,  to  any  part 
of  the  body.  The  most  usual  pain  is  a  dull  aching 
after  meals  at  the  pit  of  the  stomach,  which  is  in- 
creased on  pressure  either  with  the  palm  of  the  hand 
or  with  the  tip  of  the  finger.  In  some  cases  pain, 
though  not  severe,  is  constant,  being  no  greater  after  a 
meal  than  when  the  stomach  i§  empty,  and  often  being 
apparently  relieved  by  blancl  food,  but  coming  on  again 


174  THE    STOMACH. 

f 

as  soon  as  the  stomach  is  empty.  This  sort  of  pain  is 
usually  accompanied  by  a  pain  beneath  the  shoulder. 
It  indicates  congestion  of  the  mucous  membrane  of  the 
stomach,  and  being  usually  preceded  by  the  sense  of 
weight  already  described,  is  doubtless  indicative  of 
gastric  catarrh,  in  many  instances  at  least. 

Sometimes  pain  felt  in  the  stomach  comes  wholly 
from  increased  sensibility  of  the  mucous  membrane. 
This  condition  is  accompanied  by  abnormal  sensibility 
elsewhere,  in  most  cases,  and  commonly  occurs  in  per- 
sons of  hysterical  tendencies,  chiefly  in  young  ladies. 
It  not  infrequently  accompanies  the  condition  rather 
vaguely  known  as  "spinal  irritation."  I  have  nearly 
always  found  tenderness  at  the  epigastrium  present  in 
cases  in  which  there  was  marked  tenderness  of  the 
dorsal  spine,  and  I  have  also  noted  that  in  these  cases 
pain  is  always  present  at  two  important  diagnostic  points, 
known  as  Burkart's  tender  points,  situated  about  two 
inches  on  each  side  of  the  umbilicus.  The  tenderness 
at  these  points  is  elicited  by  deep  pressure,  with  the 
patient  lying  on  his  back  and  the  knees  drawn  up. 

A  constant,  wearing  pain,  though  not  severe,  often 
becomes  unbearable  from  its  long  continuance.  It 
gives  to  a  person  a  haggard,  despairing  look,  which  is 
also  in  part  due  to  deprivation  of  sleep,  another  ill  con- 
sequence of  this  variety  of  pain.  The  local  pain  is 
often  aggravated  by  shooting  pains  emanating  from  the 
pit  of  the  stomach,  and  running  into  the  limbs  and 
other  parts  of  the  body.  Patients  frequently  complain 
of  a  pain  felt  "clear  through  the  body,"  starting  from 
the  pit  of  the  stomach,  and  terminating  in  a  tender 
spot  in  the  spine  nearly  opposite. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  175 

Fain  accompanied  by  vomiting  of  blood  is  indicative 
of  gastric  ulcer  or  of  some  other  severe  structural 
trouble.  Flatulence  produces  a  pain  peculiar  to  itself. 
Neuralgia  of  the  stomach  is  one  of  the  most  severe 
pains  an  individual  can  experience,  often  coming  on 
suddenly,  and  in  many  cases  soon  after  eating,  and  by 
its  intensity  not  infrequently  causing  fainting. 

Soreness  on  pressure,  with  neuralgic  and  other 
pains,  also  exists  in  the  small  intestines  in  some  cases  of 
dyspepsia,  the  conditions  being  essentially  the  same  as 
those  present  in  stomach  pain. 

It  should  be  remarked  in  this  connection  that  the 
various  pains  referred  to  are  often  mistaken  for  other 
diseases.  The  pain  in  the  chest  leads  the  patient  and 
his  friends  to  believe  that  he  has  consumption  ;  and  the 
emaciation  occasioned  by  the  defective  nutrition  seems 
to  confirm  this  opinion.  If  the  patient  has  a  slight 
cough,  this  diagnosis  is  considered  certain,  and  he  is 
hurried  off  to  Florida,  California,  Colorado,  or  some 
other  locality  supposed  to  be  favorable  for  consump- 
tives. By  change  of  air,  scenery,  diet,  increase  of  ex- 
ercise, etc.,  the  patient  recovers,  and  the  locality  visited 
gets  the  credit  of  having  cured  a  case  of  consumption, 
when  the  lungs  have  been  sound  from  the  first.  If  the 
patient  stays  at  home,  some  quack  or  a  worthless  nos- 
trum is  quite  likely  to  get  the  credit,  and  every  real  con- 
sumptive who  hears  of  the  wonderful  cure  forthwith  tries 
the  same  remedy,  but  of  course  without  benefit. 

Such  cases  occur  constantly,  yet  it  must  not  be  sup- 
posed that  all  pains  in  the  chest  come  from  the  stomach. 
The  same  mistake  is  made  in  respect  to  other  pains. 
In  the  region  of  the  heart,  it  is  supposed  to  be  heart 
12 


176  THE    STOMACH. 

disease,  especially  if  there  is  sympathetic  palpitation  of 
that  organ  !  Pain  between  the  shoulders  is  spinal  dis- 
ease. Occurring  lower  in  the  spine,  it  is  thought  to  be 
kidney  trouble,  especially  if  there  happens  to  be  a  sedi- 
ment in  the  urine.  Pain  in  the  duodenum,  occurring 
just  beneath  the  lower  border  of  the  ribs  on  the  right 
side,  is  "liver  complaint,"  and  is  accordingly  treated 
by  a  plaster  or  a  "liver  pad  "  ! 

It  is  often  difficult  to  undeceive  the  patient,  and  to 
relieve  him  of  the  idea  that  he  is  suffering  from  some 
terrible  organic  malady, — an  ulcerated  lung,  an  abscess 
of  the  liver,  incurable  disease  of  the  heart  or  some  other 
organ. 

The  superficial  character  of  these  pains,  and  the 
readiness  with  which  pain  is  developed  by  pressure  of 
the  finger  upon  certain  tender  points,  which  for  the 
most  part  lie  between  the  ribs,  along  on .  either  side  of 
the  sternum  and  the  spine,  and  half-way  between  the 
sternum  and  the  spine,  is  sufficient  evidence  that  they 
do  not  arise  from  disease  of  the  deep  structures,  or  the 
organs  which  lie  within  the  trunk.  It  should  be  re- 
membered, however,  that  disease  of  the  lungs,  liver,  or 
other  internal  organs  may  exist  in  connection  with  these 
superficial  pains.  Pains  of  the  character  described  are 
generally  due  to  irritation  of  the  sympathetic  nerve 
either  from  the  presence  of  acrid  substances  in  the 
stomach  or  from  a  strain  upon  the  sympathetic  nerves 
produced  by  prolapse  of  the  bowels  or  stomach,  or  the 
constant  pull  upon  these  nerves  by  a  floating  or  wan- 
dering kidney,  a  condition  frequently  associated  with 
prolapse  of  the  stomach,  and  the  dyspeptic  symptoms 
arising  from  this  condition. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.          177 

Migraine,  or  nervous  headache,  is,  in  the  writer's 
experience,  always  associated  with  dilatation  of  the 
stomach,  and  the  formation  within  the  stomach  of  poi- 
sons or  poisonous  substances,  or  the  strain  upon  the 
sympathetic  nerves  caused  by  prolapse  or  dilatation  of 
the  stomach  and  associated  organs. 

Pain  may  exist  in  the  stomach,  liver,  bowels,  or 
other  organs  concerned  in  digestion,  as  the  result  of  dis- 
ease of  the  pneumogastric  nerve  —  the  nerve  of  sensation 
for  these  as  well  as  the  other  organs  of  the  abdomen. 

Treatment.  —  The  treatment  consists  of  the  hot- water 
or  mustard  fomentation  (10,  11),  hot  trunk  pack  (7), 
wet  girdle  (9),  abdominal  supporter  (4-5),  and  aseptic 
dietary  (Diet  List  No.  1)  or  a  dietary  of  well-disinte- 
grated foods  (Diet  List  No.  7).  In  extreme  cases, 
a  liquid  diet  (Diet  List  No.  11),  the  use  of  granose, 
bromose,  and  kumyzoon  (Diet  List  No.  25),  electricity 
to  the  spine,  stomach,  and  abdomen  (65,  67,  69),  and 
the  general  treatment  recommended  elsewhere  for  ' '  Un- 
easiness at  the  Stomach' '  (page  155)  should  be  employed. 

Biliousness. —  What  is  termed  "biliousness,"  or 
' '  a  bilious  attack, ' '  is  really  acute  gastric  catarrh.  From 
the  long  retention  of  undigested  food,  the  stomach  be- 
comes irritated  to  such  a  degree  that  nausea  and  vomit- 
ing are  produced.  At  first  the  matters  vomited  consist 
of  undigested  food  in  an  advanced  stage  of  decomposi- 
tion, as  indicated  by  the  foul  odor  and  nauseous  taste. 
After  vomiting  has  continued  for  some  time,  bile  and 
mucus  are  the  principal  matters  expelled.  The  patient 
soon  feels  better,  and  in  a  few  days  is  as  well  as  ever. 
In  these  cases  the  difficulty  is  really  in  the  stomach, 
and  not  in  the  liver,  as  many  suppose,  though  such 


178  THE    STOMACH. 

attacks  may  be  accompanied  by  disturbance  of  the 
functions  of  the  liver.  The  irritation  extends  down 
to  the  duodenum,  its  mucous  membrane  becoming  so 
swollen  that  the  opening  of  the  duct  from  the  liver 
is  obstructed.  This  occasions  retention  of  the  bile, 
and  absorption  takes  place,  when  the  individual  notices 
a  jaundiced  color  of  the  skin,  a  dingy  appearance  of 
the  white  of  the  eye,  etc.  This  is  what  gives  to  this 
symptom,  or  group  of  symptoms,  the  term  biliousness, 
when  it  is  really  gastric  catarrh. 

One  of  the  most  common  causes  of  acute  gastric 
catarrh  is  ' '  taking  cold  ' '  after  overeating  or  eating 
food  difficult  of  digestion. 

Biliousness  is  due  to  the  abnormal  development  of 
poisons  in  the  stomach  or  intestines,  and  the  failure  of 
the  liver  to  destroy  these  poisons  or  remove  them  from 
the  blood.  A  healthy  liver  is  able  to  protect  the  body 
from  an  ordinary  amount  of  poisonous  substances  ;  but 
when  a  person  indulges  in  such  gross  articles  of  diet  as 
cheese,  raw  oysters,  rich  gravies,  fat  meats,  or  habitu- 
ally makes  free  use  of  meats  of  any  sort,  or  paralyzes 
his  stomach  by  the  use  of  alcohol,  tobacco,  tea,  or 
coffee,  and  in  cases  in  which  the  stomach  retains  its 
food  for  too  long  a  time  as  the  result  of  dilatation  or 
prolapse  from  corset  wearing,  the  poor  liver  is  over- 
whelmed with  such  a  quantity  of  poisons  that  it  is 
unable  to  completely  disinfect  the  blood  brought  to  it 
from  the  stomach  and  intestine  ;  consequently  the  whole 
system  is  invaded  by  them,  and  a  condition  of  general 
systemic  poisoning,  or  what  Professor  Bouchard  terms 
"autointoxication,"  or  self -poisoning,  is  produced. 
It  will  readily  be  seen  that  biliousness  is  not  due  to 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.          179 

torpidity  of  the  liver,  but  to  abuse  of  the  liver.  The 
liver  does  its  work  as  well  as  it  can  under  the  circum- 
stances. The  thick  brown  coat  upon  the  tongue  and 
the  bad  taste  in  the  mouth  experienced  by  bilious 
persons  are  indicative  of  an  unclean  state  of  the  whole 
alimentary  canal  and  the  general  poisoning  of  the  entire 
body.  It  is  not  simply  the  patient's  tongue  which 
tastes  bad,  but  it  is  he  himself.  The  relief  obtained 
by  the  use  of  mercury  and  other  so-called  cholagogues 
is  not  due  to  the  stimulation  of  the  liver,  as  is  generally 
supposed,  but  rather  to  the  disinfection  of  the  alimen- 
tary canal  through  the  carrying  off  of  a  quantity  of  germs 
and  decaying  substances. 

The  treatment  of  this  condition  should  be  the  same 
as  is  elsewhere  recommended  for  "Bilious  Dyspepsia  " 
(see  page  251). 

Appearance  of  the  Tongue. —  While  the  im- 
portance of  the  condition  of  the  tongue  as  a  symptom 
of  dyspepsia  is  such  as  to  make  its  mention  necessary, 
it  should  be  borne  in  mind  that  its  indications  have 
more  distinct  reference  to  the  system  in  general  than 
to  the  stomach  in  particular.  A  clean  tongue,  of 
natural  color,  appearance,  and  moisture,  is  a  pretty 
sure  indication  of  health.  Unnatural  redness  of  the 
tongue,  most  commonly  at  the  tip  and  edges,  some- 
times with  a  strawberry  appearance,  indicates  an  irrita- 
ble state  of  the  stomach.  It  is  usually  accompanied 
by  soreness  at  the  pit  of  the  stomach,  little  appetite, 
arid  great  thirst. 

A  yellowish  or  creamy  coating  on  the  tongue  in- 
dicates an  inactive  state  of  the  stomach  and  intestines, 
giving  rise  to  a  foul  condition  of  the  organs.  If  a 


180  THE    STOMACH. 

small  portion  of  the  slimy  yellow  or  brownish  material 
covering  the  tongue  is  planted  upon  the  cut  surface  of 
a  boiled  potato,  and  exposed  in  a  moist  room  for  a  few 
days,  the  potato  will  be  found  covered  with  a  thick 
growth  of  germs  closely  resembling  that  upon  the 
tongue,  demonstrating  that  the  coat  upon  the  tongue  is 
really  a  growth  of  fungi  similar  to  a  patch  of  mold 
upon  the  wall. or  mildew  upon  a  garment.  When  this 
condition  exists,  not  only  the  tongue,  but  the  stomach, 
is  also  infested  with  these  mischief -making  microbes. 
The  bad  taste  experienced  in  connection  with  a  foul 
tongue  is  due  to  the  production  of  poisons  by  the 
germs.  The  headache,  nausea,  loss  of  appetite,  and 
other  symptoms  which  often  accompany  a  coated 
tongue,  and  the  bad-  taste  in  the  mouth,  are  due  to  the 
absorption  of  these  poisons  from  the  stomach,  where 
they  are  often  produced  in  enormous  quantities.  Plate 
Y  shows  the  appearance  of  germs  from  the  tongue  and 
the  stomach  as  seen  growing  upon  the  cut  surface  of 
a  sterilized  potato,  and  also  the  appearance  of  these 
germs  as  seen  under  the  microscope. 

A  white  coat  on  the  tongue  indicates  a  feverish  con- 
dition. This  often  appears  in  connection  with  unnatu- 
ral redness  at  the  edges  and  tip,  indicating  irritation. 

A  broad,  pale,  flabby  tongue  indicates  a  weakened, 
debilitated  condition  of  the  digestion  and  of  the  whole 
system.  A  tongue  of  this  sort  usually  exhibits  inden- 
tations on  its  margin,  formed  by  the  teeth,  owing  to  its 
flabby  state,  usually  present  in  hypopepsia. 

A  brown  coat  upon  the  tongue  is  very  common  in 
acute  dyspepsia.  It  is  often  accompanied  by  a  bad 
taste  in  the  mouth,  with  unnatural  dryness.  Sometimes 


FIG.  1. —  Mouth  Germs  Found  upon  the  Surface  of  a 
Coated  Tongue,  greatly  magnified. 


FIG.  2.—  Germs  which  Cause  Decay  FIG.  3.—  Germs  found  in  the  Stomach  Fluid 

of  the  Teeth.  after  a  Test  Meal,  greatly  magnified. 


PLATE  V. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  181 

this  is  due  to  sleeping  with  the  mouth  open,  by  which 
the  secretions  and  epithelium  become  dried  to  an  un- 
natural extent. 

Sometimes  the  tongue  is  coated  in  the  middle,  the 
edges  being  smooth  and  clean.  This  is  due  to  the  fact 
that  the  epithelium  has  become  softened  on  the  smooth 
portions,  and  has  been  rubbed  off  by  the  friction  of  the 
teeth.  Clean  spots  are  also  due  to  lost  epithelium,  in 
many  cases. 

Transverse  fissures  of  the  tongue  indicate  a  diseased 
state  of  the  mucous  membrane  of  the  stomach,  usu- 
ally due  to  acid  dyspepsia. 

Treatment. — A  yellow  or  brown  coat  upon  the  tongue 
indicates  an  infected  condition  of  the  stomach,  which 
requires  the  treatment  recommended  for  "  Bilious  Dys- 
pepsia "  (page  251).  A  broad  or  pale,  flabby  tongue 
indicates  hypopepsia,  and  requires  the  treatment  recom- 
mended for  this  condition  (see  page  260).  In  cases 
accompanied  by  rise  of  temperature,  the  patient's  diet 
should  be  carefully  restricted  to  such  foods  as  are 
suitable  in  fever  (Diet  List  No.  12).  Fine  charcoal 
(4-7,  4-8)  should  be  freely  used  in  cases  in  which  the 
tongue  is  unusually  foul,  and  the  patient  should  be 
made  to  drink  water  freely.  The  amount  taken  in 
twenty-four  hours  should  usually  be  from  three  to  six 
pints  More  is  often  advantageous. 

Aphthae. — In  cases  of  acidity  of  the  stomach,  oc- 
casioning irritability  of  the  organ,  little  pimples  often 
appear  on  the  sides  and  under  part  of  the  tongue,  and 
just  within  the  corners  of  the  mouth.  After  a  short 
time,  email  white  patches  of  lymph  may  be  seen,  which 
frequently  leave  very  troublesome  little  ulcers  when 


182  -    THE    STOMACH. 

they  disappear.  These  very  annoying  ulcers  are  posi- 
tive evidence  of  stomach  disorder,  though  the  patient 
will  often  assert  that  he  has  no  difficulty  with  his  food, 
and  never  experiences  any  pain  or  inconvenience  con- 
nected with  the  stomach. 

Aphthae  are  probably  most  often  present  in  cases  of 
hyperpepsia,  or  excessive  secretion  of  the  gastric  juice  ; 
but  the  writer  has  also  found  them  present  in  hypo- 
pepsia. 

Treatment. —  The  mouth  should  be  thoroughly 
cleansed  after  each  meal  ;  it  should  be  rinsed  every 
hour  with  a  saturated  solution  of  boric  acid  or  chlorate 
of  potash.  The  ulcers  may  be  touched  with  a  solution 
—  forty  grains  to  the  ounce  —  of  nitrate  of  silver,  after 
being  carefully  dried.  Treatment  for  either  hyperpep- 
sia or  hypopepsia  should  be  employed,  according  to  the 
indications  of  other  symptoms. 

"  Throat-Ail."-  —  Congestion  of  the  pharynx,  with 
a  granular  condition  of  the  mucous  membrane,  relaxation 
and  elongation  of  the  uvula,  accompanied  by  a  sense  of 
constriction,  tightness,  dryness,  tickling,  and  other 
symptoms,  are  not  infrequent  indications  of  stomach 
disorder.  The  patient  is  often  much  troubled  with  a 
tenacious  mucus  which  he  finds  difficulty  in  dislodging. 
Sometimes  the  throat  trouble  amounts  to  real  difficulty 
in  swallowing. 

What  is  known  as  "clergyman's  sore  throat"  is 
usually  associated  with  disorders  of  digestion. 

Treatment  —  Fomentations  (10,  11)  applied  to  the 
throat  at  night,  and  followed  by  a  cold  compress,  well 
covered,  to  be  worn  during  the  night,  and  a  cold  sponge 
bath  (1)  with  vigorous  rubbing  in  the  morning,  are  ex- 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  183 

cellent  remedies  for  hoarseness.  Gargling  hot  water 
in  the  throat  three  or  four  times  a  day  is  also  useful. 
The  vaporizer  (59,  60)  should  be  used  five  or  six  times 
a  day,  five  to  ten  minutes  each  time.  It  may  be  used 
to  advantage  even  more  frequently,  if  convenient.  The 
course  of  tonic  treatment  and  the  general  measures 
indicated  for  slow  digestion  should  be  employed. 

Sour  Taste  in  the  Mouth. — This  symptom, 
not  a  very  infrequent  one,  is  due  to  an  acid  condition 
of  the  saliva,  which  not  only  renders  it  of  little  use  as  a 
digestive  fluid,  but  also  ruins  the  teeth,  by  destroying 
the  enamel. 

In  anomalous  cases  the  saliva  has  a  sweetish  taste. 

In  inactive  conditions  of  the  liver,  it  is  likely  to  be 
bitter,  so  that  the  patient  complains  constantly  of  a  bit- 
ter taste  in  the  mouth.  Viscidity  of  the  saliva,  accom- 
panied by  an  unpleasant  sense  of  heat  in  the  mouth  in 
the  morning,  is  a  common  indication  of  derangement 
of  digestion. 

In  the  careful  examination  of  the  saliva  in  a  large 
number  of  cases,  I  have  found  acidity  present  much 
more  often  than  I  had  formerly  suspected.  A  careful 
examination  of  the  condition  of  the  digestive  organs 
must  hence  include  an  investigation  of  the  condition  of 
the  saliva  as  regards  its  chemical  reaction  and  its  digest- 
ive activity. 

Treatment. —  Rinse  the  mouth  with  a  solution  of  car- 
bonate of  soda  (64)  three  or  four  times  daily  ;  cleanse 
the  mouth  thoroughly  before  and  after  each  meal  with  an 
antiseptic  dentifrice  (57),  or  rinse  the  mouth  with  cin- 
namon water  (58),  cleansing  by  ordinary  means.  The 
diet  and  other  treatment  should  be  such  as  is  recom- 


184  THE    STOMACH. 

mended  for  "Simple  Dyspepsia"  with  fermentation  (see 
page  245). 

Constipation. — Though  often  an  accompaniment 
of  dyspepsia,  this  condition  is  not  a  constant  one  in 
that  disease.  There  seems  to  be  a  quite  general  error 
on  this  point,  since  many  patients  confound  the  use  of 
the  term  indigestion  with  constipation.  I  have  often 
been  told  by  patients,  in  answer  to  an  inquiry  respect- 
ing the  state  of  the  bowels,  that  their  "digestion  "  was 
very  regular,  or  very  irregular,  as  the  state  of  the 
bowels  happened  to  be.  A  person  may  have  very  poor 
stomach  digestion  without  any  marked  disturbance  of 
the  bowels;  yet  constipation,  or  costiveness, —  some 
make  a  distinction  between  the  two, — is  very  rarely 
present  without  disorder  of  some  sort  in  the  digestive 
apparatus. 

As  a  rule,  it  may  be  expected  that  any  disturbance 
in  the  function  of  those  digestive  organs  which  lie 
below  the  stomach  are  secondary  to  disease  of  the 
stomach.  Intestinal  catarrh  follows  gastric  catarrh ; 
cirrhosis  of  the  liver,  jaundice,  gall-stones,  and  other 
hepatic  affections  are  also  consequences  of  chronic 
gastric  or  gastro-intestinal  catarrh.  Biliousness  also 
begins  in  the  stomach,  as  has  been  shown.  Cancer 
of  the  liver  is  nearly  always  secondary  to  disease  of 
the  stomach. 

In  constipation  there  may  be  either  excessive  hard- 
ness of  the  fecal  matters  through  too  long  retention, 
and  consequently  too  great  absorption  of  the  fluid  por- 
tion, or  there  may  be  loss  of  nerve  sensibility  at  the 
lower,  or  anal,  orifice  of  the  intestinal  canal. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  185 

Treatment. — For  the  treatment  of  this  condition, 
see  page  279. 

Diarrhea. —  This  also  is  as  marked  a  symptom  of 
dyspeptic  conditions  as  the  preceding,  though  less 
frequent.  Whether  constipation  or  looseness  is  pres- 
ent depends  on  the  particular  form  of  indigestion. 
When  the  most  prominent  difficulty  is  slow  digestion, 
constipation  is  usually  present.  In  bilious  dyspepsia,  the 
decomposition  of  the  food  gives  rise  to  such  a  degree 
of  irritation  that  diarrhea  is  induced.  Diarrhea  in 
these  cases  is  doubtless  the  result  of  the  effect  of 
poisonous  substances  generated  by  the  germs  develop- 
ing in  the  alimentary  canal,  and  which  the  digestive 
fluids  have  failed  to  destroy. 

Diarrhea  is  also  present  in  cases  in  which  there  is 
so  great  irritability  of  the  mucous  membrane  that  the 
food  is  hastened  along  without  complete  digestion. 
Not  infrequently  the  two  conditions  constipation  and 
diarrhea,  alternate,  each  being  occasioned  by  the  other, 
the  vital  forces  b.eing  too  weak  to  maintain  a  healthy 
medium  of  activity.  Hardened  fecal  matters  are 
retained  until  they  become  a  source  of  irritation,  then 
diarrhea  ensues  until  the  bowels  have  been  emptied,  in 
part  at  least,  this  excessive  activity  being  followed  by  a 
return  of  the  constipation. 

Treatment. —  The  treatment  of  this  symptom  will 
vary  according  to  the  conditions  which  gave  rise  to  it. 
If  other  symptoms  indicate  foul  or  bilious  dyspepsia, 
then  the  treatment  elsewhere  recommended  for  this  con- 
dition should  be  employed,  together  with  a  large  hot 
enema  administered  daily.  Charcoal  (47,  48)  or 


18H  THE    STOMACH. 

antiseptic  charcoal  tablets  (4-9)  should  be  habitually 
used. 

When  diarrhea  is  due  to  excessive  irritability  of  the 
mucous  membrane  of  the  stomach,  indicated  by  a  red, 
sensitive  tongue  and  other  symptoms  of  irritation  of  the 
alimentary  canal,  liquid  food  (Diet  List  No.  11)  or  food 
which  will  readily  dissolve  in  the  stomach  (Diet  List  No. 
7)  should  be  used.  A  diet  of  kumyzoon  (Diet  List  No. 
25),  kumyss,  or  buttermilk  is  sometimes  required.  An 
enema  taken  after  each  movement  to  cleanse  the  bowels, 
fomentations  (10),  a  wet  girdle  (9),  and  in  cases  of 
prolapse  of  the  bowels,  with  dragging  sensation  across 
the  abdomen,  the  abdominal  supporter,  are  very  help- 
ful measures  used  in  connection  with  those  means 
which  are  indicated  by  other  symptoms  of  indigestion. 
In  old  and  very  feeble  patients,  ' '  Nutritive  Treatment ' ' 
(page  331),  and  in  stronger  subjects,  "Tonic  Treat- 
ment "  (page  333)  should  be  employed. 

Long,  patient,  and  persevering  treatment  is  re- 
quired in  these  cases.  Sometimes  in  chronic  diarrhea, 
the  "Rest-Cure"  (see  page  329)  for  two  or  three 
weeks,  and  a  diet  consisting  chiefly  of  kumyss,  kumy- 
zoon, or  buttermilk,  and  eggs  is  necessary  to  give  the 
patient  a  good  start  in  the  direction  of  health.  The 
daily  hot  enema  (22)  and  "  General  Tonic  Treatment  " 
(page  333)  are  required  in  these  cases. 

Backache. —  This  symptom  is  so  common  in  dys- 
pepsia that  it  requires  separate  consideration.  A 
chronic  ache  in  the  lower  part  of  the  back  is  due  to  an 
irritation  of  the  lumbar  ganglia  of  the  sympathetic  nerve 
(page  193).  Pain  or  soreness  between  the  shoulders  is 
due  to  irritation  of  the  solar  plexus.  The  symptoms 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.          187 

arise  most  frequently  from  prolapse  and  dragging  of  the 
stomach  and  bowels.  Prolapse  of  one  or  both  kidneys 
or  of  the  liyer  or  spleen  is  also  frequently  present  in 
these  cases.  Examination  of  the  abdomen  shows  a 
sagging  or  abnormal  protrusion  of  the  abdomen  at  its 
lower  portion.  In  these  cases  tenderness  is  found 
on  making  deep  pressure  at  points  two  inches  on 
either  side  of  the  umbilicus.  Constipation  is  usually 
present. 

Treatment. — The  following  measures  will  be  found 
the  most  effective  :  "General  Tonic  Treatment  "  (page 
333),  fomentations  (10, 11)  to  the  spine,  hot  and  cold  to 
the  spine  (18),  hot  and  cold  trunk  pack  (8),  applications 
of  electricity  to  the  spine  (65,  67,  69),  Swedish  move- 
ments (41).  Proper  measures  for  the  relief  of  consti- 
pation should  be  employed  (see  page  279). 

The  Stools. —  Quite  too  little  attention  is  paid  to 
the  character  of  the  bowel  discharges  by  physicians  as 
well  as  by  patients.  In  all  cases  of-  dyspepsia,  they 
should  be  carefully  and  frequently  examined.  The 
stools  should  be  well-formed  and  of  moderate  consist- 
ency. Bagged,  unformed  stools  indicate  some  degree 
of  irritability  of  the  digestive  tract.  Watery  stools 
show  deficient  absorption,  or  too  profuse  secretion  from 
the  mucous  membrane.  Slimy  discharges  indicate  a 
catarrhal  condition.  Small,  pellet-like  masses  are 
indicative  of  constipation  due  to  deranged  function 
of  the  colon.  If  the  discharges  are  unnaturally  light 
in  color,  too  little  bile  is  present.  An  unnaturally  dark 
color,  with  very  offensive  odor,  often  accompanies  foul 
dyspepsia.  The  appearance  of  portions  of  undigested 
food  indicates  great  inactivity  of  the  digestive  organs. 


188  THE    STOMACH. 

A  microscopic  examination  is  often  extremely  useful, 
as  by  this  means  it  can  be  ascertained,  in  many  cases, 
what  particular  element  of  the  food  may  not  be  well 
digested.  For  example,  if  fat  globules  are  found  in 
great  abundance,  the  indigestion  of  fat  or  oleaginous 
substances  is  indicated ;  if  portions  of  undigested  meat 
are  discovered,  difficulty  in  digesting  animal  food  will 
be  understood. 

Examination  of  the  fecal  discharges  also  affords  the 
only  reliable  evidence  of  worms,  as  by  this  means  eggs, 
if  not  the  worms  themselves,  may  certainly  be  found  if 
they  are  present.  Examination  for  the  eggs  of  para- 
sites requires  the  use  of  the  microscope  in  the  hands  of 
an  expert. 

Treatment. — The  treatment  required  for  abnormal 
conditions  of  the  fecal  matters  varies  according  to  the 
indications.  Dark,  offensive  fecal  matters  indicate  a 
foul  condition  of  the  alimentary  canal,  requiring  an 
aseptic  dietary  (Diet  List  No.  1),  charcoal  or  antiseptic 
charcoal  tablets  (47,  4-8,  4-9),  and  the  general  measures 
recommended  for  bilious  dyspepsia.  Bilious  or  septic 
indigestion  (page  251),  with  slight  discharges,  indicates 
a  catarrhal  condition  of  the  bowels.  The  presence  of 
mucus  in  excessive  quantity  indicates  a  catarrhal  condi- 
tion of  the  intestines.  If  the  mucus  is  discharged  first, 
a  catarrhal  condition  of  the  lower  portion  of  the  rectum 
exists.  If  the  mucus  follows  the  fecal  discharge,  the 
catarrhal  condition  is  located  higher  up  in  the  bowel. 
If  the  mucus  is  mixed  throughout  the  fecal  mass,  it  is 
probable  that  a  considerable  portion  of  the  colon  is  af- 
fected. This  condition  requires  an  aseptic  dietary  (Diet 
List  No.  1),  especially  the  disuse  of  all  forms  of  flesh 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  189 

food,  the  use  of  charcoal  (4-7,  4?8,  4-9),  a  large  hot 
enema  daily,  to  thoroughly  cleanse  the  bowels,  to  be 
followed  by  an  astringent  enema  consisting  of  a  drain 
of  tannin  to  a  quart  of  water,  the  last  to  be  retained 
for  half  an  hour,  if  possible.  Masses  of  undigested 
food  indicate  the  need  of  a  dietary  consisting  of  well- 
disintegrated  food  substances  (Diet  List  No.  7). 

For  a  liquid  dietary  (Diet  List  No.  11),  in  extreme 
cases,  a  diet  of  kumyzoon  (Diet  List  No.  25),  kumyss, 
or  buttermilk  is  required. 

The  Urine. —  Examination  of  the  urine  is  im- 
portant, though  little  need  be  said,  on  this  point,  as  a 
reliable  examination  can  be  made  only  by  a  competent 
physician.  A  white,  pink,  reddish,  or  brick-dust  sedi- 
ment is  very  common  in  dyspepsia,  together  with  other 
deposits.  These  are  most  often  found  after  an  unusu- 
ally severe  attack  of  indigestion.  The  fact  that  deposits 
in  the  urine  are  frequent  in  this  disease,  is  mentioned 
more  particularly  because  those 
who  .are  ignorant  on  the  subject 
are  often  led,  by  the  advice  of 
quacks  or  otherwise,  to  take  this 
as  evidence  of  disease  of  the  kid- 
neys, of  which  it  is  not  a  posi- 
tive indication.  These  deposits 

FIG.  18.— URIC  ACID 

are  the  result  of  the  inability  of  CRYSTALS. 

the  liver  to  oxidize,  or  reduce  to  urea,  the  great  quantity 
of  imperfectly  prepared  matter  thrown  into  the  blood. 
They  are  particularly  liable  to  be  present  in  persons 
who  use  considerable  meat.  (See  Fig.  18.) 

Treatment.  —  A  white,  pinkish,  reddish,  or  brick- 
dust  sediment  indicates  the  necessity  for  an  aseptic  diet 


190  THE    STOMACH. 

(Diet  List  No.  1),  and  especially  the  avoidance  of  all 
articles  hard  to  digest  and  likely  to  undergo  fermenta- 
tion (Diet  Lists  Nos.  22,  23),  and  the  disuse  of  meat. 
This  condition  often  precedes  Bright' s  disease,  and 
should  receive  careful  attention.  The  patient  should 
drink  from  three  to  six  pints  of  water  daily,  and  should 
exercise  out  of  doors  two  or  three  hours  daily,  the  exer- 
cise being  as  vigorous  as  is  consistent  with  the  strength 
of  the  patient.  A  hot  bath  of  some  kind  once  or  twice 
a  week,  and  ' '  General  Tonic  Treatment ' '  (see  page  333) 
should  be  employed.  Fomentations  (11)  over  the  liver 
daily,  and  the  wet  girdle  (9)  are  also  measures  of  value. 

Dry  ness  of  the  Skin. —  A  peculiar  dry,  rough 
condition  of  the  skin  is  very  common  in  dyspepsia, 
though  not  peculiar  to  the  disease.  In  these  cases,  the 
natural  secretion  of  the  skin  is  greatly  diminished.  The 
patient  will  frequently  complain  that  he  never  sweats. 

In  some  forms  of  dyspepsia,  the  opposite  condi- 
tion is  present,  the  skin  being  tawny,  and  having  a 
greasy  feeling.  Occasionally  it  is  unusually  clear, 
pliable,  and  sensitive,  sometimes  being  almost  trans- 
parent. These  cases  usually  occur  among  nervous 
dyspeptics. 

Treatment. — "General  Tonic  Treatment"  and  a 
daily  oil  rub  (27)  are  indicated  for  the  relief  of  this 
condition. 

Skin  Eruptions. —  The  use  of  particular  articles 
of  food  will  in  certain  individuals  give  rise  to  various 
skin  eruptions  soon  after  eating,  the  eruption  being 
accompanied  by  marked  evidences  of  indigestion. 
Eczema,  acne,  and  other  skin  diseases  are  chiefly 
dependent  upon  disordered  digestion.  All  the  glandu- 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  191 

lar  structures  of  the  body  are  controlled  by  the  sympa- 
thetic nervous  system.  In  diseases  of  the  stomach, 
this  nerve  is  certain  to  be  more  or  less  affected,  and 
hence  disturbance  arises  in  the  glands  as  well  as  in  the 
other  structures  under  the  control  of  the  sympathetic 
nerves.  Indigestion  is  in  this  way  the  principal  cause 
of  acne,  or  pimples  of  the  face. 

Treatment. —  Relief  of  the  digestive  disorder  by 
"General  Tonic  Treatment"  (see  page  333),  should 
first  be  sought.  Zinc  ointment,  obtainable  from  any 
drug-store,  may  be  applied  to  the  eruptions.  For  chronic 
cases  of  eczema,  with  a  thickening  of  the  skin,  the  daily 
application  of  hot  water  by  moist  cloths  (10)  or  a  hot  pour 
(19)  is  a  proper  measure  to  be  employed.  Acne  some- 
times requires  the  use  of  a  hot  solution  of  corrosive 
sublimate,  one  part  of  the  sublimate  to  two  hundred  of 
water,  after  a  thorough  cleansing  of  the  parts  with  soap 
and  water.  Care  should  be  taken  not  to  get  the  solution 
into  the  eyes  or  mouth,  as  it  is  very  poisonous.  Use 
daily  for  five  minutes. 

Cold  Feet,  etc. —  To  cure  cold  feet,  do  not  heat 
them  at  the  fire  nor  parboil  them  in  hot  water  ;  this 
only  relaxes  and  weakens  the  circulation.  A  better 
plan  is  this  :  Just  before  going  to  bed,  place  the  feet  in 
a  cold  bath,  with  the  water  about  one  fourth  of  an  inch 
deep.  In  a  few  minutes,  dry  and  rub  warm  with  a 
coarse  cloth  or  with  the  hand.  The  alternate  hot  and 
cold  foot  bath  may  be  used  with  still  greater  effective- 
ness. At  night,  if  the  feet  cannot  otherwise  be  kept 
warm,  hot  jugs  or  foot-stones  may  be  employed  ;  but  it 
is  far  better  to  be  independent  of  such  artificial  sub- 
stitutes for  vital  heat  by  wearing  warm  bed  socks. 
13 


192  THE    STOMACH. 

When  the  feet  or  hands  are  too  hot,  they  may  be 
cooled  by  employing  cold  instead  of  heat.  Ice-water 
may  be  employed  when  necessary,  and  will  be  found  a 
most  excellent  means  of  relieving  the  unpleasant  burn- 
ing of  the  feet  from  which  many  people,  especially 
older  persons,  often  suffer  much. 

Coldness  of  the  extremities  in  dyspeptics  is  due  to 
an  irritated  condition  of  the  abdominal  sympathetic 
nerve,  whereby  the  blood-vessels  are  caused  to  con- 
tract, so  that  an  insufficient  amount  of  blood  is  circu- 
lated through  the  extremities.  Patients  suffering  in 
this  way  often  complain  of  a  dragging  sensation  across 
the  lower  abdomen,  or  an  aching  in  the  back,  espe- 
cially when  obliged  to  be  much  upon  the  feet.  There 
is  also  a  disposition  to  elevate  the  feet  in  sitting,  and 
a  symptom  commonly  known  as  ' '  fidgets ' '  is  often 
present.  These  symptoms  indicate  the  necessity  for 
relief  of  the  irritation  of  the  abdominal  sympathetic, 
and  also  for  the  support  of  the  abdominal  organs,  the 
downward  displacement  of  which  is  a  cause  of  the 
irritation.  The  principal  measures  required  are  fomen- 
tations to  the  abdomen  daily,  the  wet  girdle  (9),  and 
' '  General  Tonic  Treatment  " .  ( see  page  3  3  3 ) .  The  ab- 
dominal supporter  (4>5)  should  be  worn  constantly  when 
the  patient  is  exercising  in  an  upright  position.  The 
application  of  electricity  (65,  66,  67)  and  Swedish 
movements  (40)  are  also  very  useful  measures  in  these 
cases. 

Headache. —  Various  forms  of  headache  are 
among  the  most  common  symptoms  of  dyspepsia.  In 
different  cases,  different  parts  of  the  head  are  affected, 
and  in  the  same  person  at  different  tunes.  The  whole 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  193 

head  may  be  affected,  feeling,  as  the  patient  sometimes 
says,  ' '  as  though  it  would  burst. ' '  Again,  the  pain 
may  be  confined  to  the  temples,  or  to  the  back  or  front 
of  the  head,  to  the  top  of  the  head,  to  the  region  of  the 
ears,  to  the  eyeballs,  to  the  upper  part  of  the  neck,  or 
it  may  extend  down  between  the  shoulders.  In  many 
cases  there  is  also  tenderness  of  the  part  affected. 

When  headache  occurs  during  digestion,  or  soon 
after  eating,  it  is  usually  of  a  dull,  heavy  character, 
often  located  in  the  front  part  of  the  head,  and  is 
accompanied  by  more  or  less  confusion  of  thought,  cold 
feet,  and  sometimes  dimness  of  vision.  This  form  of 
headache  is  often  accompanied  by  a  sense  of  weight  at 
the  pit  of  the  stomach. 

The  headache  which  comes  on  the  next  day  or  sev- 
eral hours  after  taking  an  indigestible  meal,  is  of  a 
more  severe  character.  It  is  commonly  accompanied 
by  pain  and  tenderness  just  below  the  ribs  on  the  right 
side,  in  the  region  of  the  duodenum,  which  is  probably 
the  part  chiefly  affected. 

Migraine,  or  Nervous  Headache. —  This  af- 
fection, long  treated  as  a  nervous  disease,  has  been 
clearly  proved  to  be  a  purely  symptomatic  malady,  re- 
sulting from  irritation  of  the  sympathetic  nerve  as  the 
result  of  the  action  of  poisons  formed  in  the  stomach. 
A  careful  study  of  a  large  number  of  these  cases  has 
convinced  the  writer  that  nervous  headache  occurs  only 
in  persons  suffering  from  dilatation  or  prolapse  of  the 
stomach.  After  having  made  a  careful  examination  of 
a  large  number  of  cases  of  this  disease,  numbering 
more  than  one  hundred  in  all,  I  am  able  to  say  that  I 
have  failed  to  find  a  single  case  in  which  there  was  not 


194  THE    STOMACH. 

evidence  of  great  irritation  of  the  abdominal  sympa- 
thetic nerve,  as  shown  by  extreme  sensitiveness  at  the 
tender  points  first  pointed  out  by  Burkart,  in  1882. 
These  points  lie  about  two  inches  on  each  side  of  the 
umbilicus,  at  the  posterior  surface  of  the  abdominal 
cavity.  An  indication  of  chronic  poisoning  which  is  al- 
most invariably  to  be  found  in  these  cases  is  the  foul 
tongue  and  malodorous  breath  presented  by  the  patient, 
and  which  afford  the  most  indubitable  evidence  of  a 
septic  condition  of  the  alimentary  canal.  A  peculiar 
bitter,  or  what  is  frequently  described  by  the  patient  as 
a  "nasty,"  taste  in  the  mouth  nearly  always  accompa- 
nies this  disease.  The  disagreeable,  and  often  fetid, 
odor  of  the  breath  is  evidently  derived  from  the  forma- 
tion of  sulphuretic  compounds,  the  extremely  toxic 
character  of  which  is  well  known.  Pepper  mentions 
cases  in  which  jewelry  worn  by  the  patient  was  always 
tarnished  during  an  attack  of  this  disease. 

Intellectual  overwork  or  worry  is  an  exciting  cause 
of  the  disease  only  through  the  fact  that  by  reflex 
action  downward  it  increases  the  sensitive  condition  of 
the  abdominal  sympathetic,  and  at  the  same  time  re- 
tards the  digestion,  and  so  favors  both  the  production 
of  toxins,  which  are  the  direct  cause  of  the  disease,  and 
the  susceptibility  of  the  sympathetic  nerve  to  the  action 
of  these  poisonous  substances. 

The  frequent  occurrence  of  attacks  of  migraine  at 
the  menstrual  period  in  women  is  occasioned  simply  by 
the  increased  sensitiveness  of  the  nervous  system  at 
that  time.  It  is  a  well-established  fact  that  both  mental 
and  nervous  disturbances  are  much  more  likely  to  occur 
in  women  at  the  menstrual  period  than  at  other  times. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  195 

Those  who  have  made  a  careful  study  of  this  dis- 
ease will  at  once  recall  many  circumstances  which  are 
confirmatory  of  these  views.  Many  have  doubtless  ob- 
served in  certain  cases  a  peculiarity  of  the  disease  men- 
tioned by  Niemeyer,  who  remarks  as  follows  :  "In 
some  cases,  a  severe  attack,  particularly  if  it  ends  with 
sick  stomach,  results  in  a  certain  immunity  to  relapses. ' ' 
Vomiting  is,  of  course,  in  some  degree  equivalent  to  a 
lavage,  and  so  affords  the  patient  temporary  exemption 
from  suffering.  The  fact  that  great  benefit  may  be  de- 
rived from  the  use  of  saline  laxatives  in  many  cases, 
the  disease  being  frequently  aborted  by  the  early  use  of 
an  active  cathartic,  is  another  confirmatory  evidence. 
It  will  also  be  remembered  that  food  of  any  kind,  no 
matter  how  simple  or  digestible,  frequently  aggravates 
the  disease,  although  there  are  occasional  cases,  as 
mentioned  by  Brinton,  in  which  the  taking  of  a  hearty 
rneal  seems  to  terminate  an  attack,  probably  by  excit- 
ing stomachic  and  peristaltic  activity.  Niemeyer  re- 
marks as  follows  with  reference  to  the  treatment  of  this 
disease  :  — 

' '  In  most  cases  we  can  do  nothing  but  attend  to 
existing  disturbances  of  the  general  health  and  of  the 
digestion,  and  the  chances  of  benefit  from  treatment 
are  much  greater  when  we  can  discover  any  such  dis- 
turbances. During  the  attack  we  should  spare  the  pa- 
tient from  the  use  of  any  remedies,  and  let  him  take 
nothing  but  water." 

Viewed  from  this  standpoint,  migraine  is  no  longer 
a  complex  or  mysterious  nervous  malady,  but  simply  a 
state  of  systemic  poisoning,  the  origin  of  which 
is  decomposition  of  food  products  in  a  dilated  or 


196  THE    STOMACH. 

prolapsed  stomach  which,  through  muscular  weakness, 
is  unable  to  rid  itself  of  its  contents  with  sufficient 
promptness  to  prevent  septic  and  putrefying  processes. 
Although  these  causes  may  be  constantly  in  operation, 
they  do  not  usually  produce  pronounced  symptoms  of 
poisoning  except  at  intervals,  the  kidneys  ordinarily  elim- 
inating the  poisonous  substances  with  sufficient  rapidity 
to  prevent  those  ' '  nerve  storms ' '  to  which  the  term 
migraine,  or  megrim,  has  been  attached,  except  when 
the  nervous  system  is  by  excessive  nervous  or  mental 
activity,  or  by  the  functional  disturbance  of  menstrua- 
tion, rendered  unusually  susceptible. 

The  remedy  for  this  malady  is  to  be  sought,  then, 
not  in  the  discovery  of  some  new  drug  which  shall  tem- 
porarily paralyze  the  nervous  sensibility,  reduce  the 
blood  pressure  or  raise  it,  as  may  be  required  in  the 
individual  case,  but  in  the  removal  of  the  real  cause  of 
the  disease.  The  writer  believes  that  every  case  of 
migraine  is  capable  of  being  radically  cured. 

Treatment, — The  treatment  required  in  these  cases 
consists  of  two  classes  of  measures  : — 

1.  Those  that  are  palliative,   or  useful    during   an 
attack. 

2.  Those  that  are  curative,  to  be  used  in  the  inter- 
vals. 

The  most  efficient  of  all  palliative  means  is  lavage,  or 
washing  out  of  the  stomach.  By  employing  lavage  (4-6) 
at  the  very  beginning  of  the  attack,  it  may  often  be  cut 
short,  and  by  adopting  this  measure  still  earlier,  as  on 
the  appearance  of  the  first  premonitory  symptoms,  it  is 
found  possible  in  many  cases  to  prevent  the  attack  al- 
together. Many  times  the  stomach-tube  brings  up  a 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  197 

great  quantity  of  ill-smelling,  undigested,  and  decompos- 
ing food.  In  other  cases,  no  food,  but  a  small  quantity 
of  clear  but  very  bitter  and  acrid  fluid,  is  obtained. 
When  there  is  very  marked  dilatation,  it  is  some- 
times necessary  to  repeat  the  lavage  a  number  of  times 
before  the  stomach  is  completely  cleared  of  its  fetid 
contents.  Not  infrequently  there  is  bile  present.  It 
should  not  be  forgotten  that  the  bowels  as  well  as  the 
stomach  may  contain  a  considerable  amount  of  decom- 
posing matter  ;  hence  a  large  hot  enema  (22)  should  be 
administered  as  a  means  of  cleansing  the  lower  portion  of 
the  alimentary  canal.  This  should  be  done  whether  the 
bowels  are  known  to  be  constipated  or  not.  The  enema 
serves  a  useful  purpose,  not  only  in  washing  out  the  bow- 
els, but  in  supplying  fluid  to  the  body,  by  which  the  kid- 
neys are  aided  in  eliminating  the  irritating  poisonous 
substances  with  which  the  blood  is  charged. 

Hot  and  cold  sponging  of  the  spine  (18),  fomenta- 
tions to  the  head  when  the  face  shows  pallor,  and  also  to 
the  stomach,  heat  to  the  extremities  if  cold,  and  appli- 
cations of  galvanic  and  faradic  electricity  (65,  70),  are 
needed.  It  must  be  admitted,  however,  that  no  reme- 
dies are  of  very  great  value  when  an  attack  is  once  fairly 
started,  although  faithful  use  of  the  measures  suggested 
will  certainly  serve  to  cut  short  the  attack.  The  use 
of  antipyrin,  migranin,  antifebrin,  and  other  allied 
drugs  is  to  be  deprecated,  for  the  reason  that  these 
drugs,  though  sometimes  temporarily  palliative,  soon 
lose  their  effect,  requiring  an  increase  of  dose  at  each 
successive  attack,  until  the  injurious  results  of  the  drug 
may  become  a  more  serious  matter  than  the  disease 
itself. 


198  THE    STOMACH. 

The  patient  should  not  eat  during  an  attack,  or  at 
least  not  until  after  the  first  twenty-four  hours.  There 
is,  however,  an  occasional  exception  to  this  rule,  in 
which  eating  after  the  omission  of  a  single  meal  seems 
to  aid  in  bringing  the  attack  to  a  termination  by  un- 
loading the  contents  of  the  stomach  into  the  intestine, 
and  thus  provoking  movement  of  the  bowels.  The 
first  food  taken  should  consist  of  some  simple  cereal  or 
fruit  preparation.  All  forms  of  flesh  foods  and  animal 
extracts,  and  also  milk,  should  be  avoided.  Tea  and 
coffee,  which  are  popular  remedies  for  sick-headache, 
are  highly  detrimental ;  for  although  they  may  some- 
times mitigate  the  symptoms  during  an  attack,  they 
prepare  the  way  for  a  speedy  recurrence  of  another. 
Granola,  granose,  zwieback,  gluten,  and  water  breads 
of  various  kinds  ;  grapes,  peaches,  in  fact,  fruits  of  all 
kinds  ;  and  such  green  vegetables  as  peas,  asparagus, 
and  string  beans,  are  wholesome  and  suitable,  but  for 
these  cases  should  be  cooked  without  milk  or  cream. 
Nuts,  if  well  chewed, —  preferably,  however,  taken  in 
the  form  of  nut  meal  (Diet  List  No.  25), —  afford  the 
most  suitable  form  of  fat.  Milk  is  allowable  only  in 
the  form  of  buttermilk,  kumyss,  kumyzoon  ( Diet  List 
No.  25),  or  cottage  cheese.  It  should  be  carefully 
sterilized. 

The  curative  treatment  of  migraine  consists  of  a  care- 
ful adherence  to  an  aseptic  dietary  (Diet  List  No.  1 ), 
special  preference  being  given  to  the  articles  mentioned. 
Everything  possible  should  be  done  to  build  up  the 
patient's  general  health.  For  this  purpose  the  cool 
morning  sponge  bath  (1),  followed  by  vigorous  rub- 
bing with  a  towel  or  flesh-brush,  and  the  wearing  of 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.          199 

the  moist  abdominal  bandage  (9)  during  the  night,  are 
especially  helpful.  Outdoor  exercise  should  be  taken 
daily  to  the  extent  of  producing  gentle  perspiration. 
Bicycle  riding  is  especially  helpful,  also  boating  and 
horseback  riding.  Patients  who  suffer  from  dilatation 
and  prolapse  of  the  stomach,  however,  should  take 
care  to  support  the  prolapsed  viscera  by  a  proper 
abdominal  supporter.  For  this  purpose  the  author  has 
devised  an  instrument  called  the  Natural  Abdominal 
Supporter  (4?  5)  which  elevates  the  viscera  in  a  manner 
exactly  similar  to  that  in  which  persons  often  support 
themselves  with  their  hands  when  they  have  an  un- 
pleasant dragging  sensation  in  the  lower  abdomen. 
Tenderness  of  the  abdominal  sympathetic  may  be 
relieved  by  the  daily  application  of  the  hot  water-bag 
for  an  hour  or  two,  or  a  fomentation  (10).  Special 
pains  should  be  taken  to  masticate  the  food  very 
thoroughly  ;  and  in  cases  of  extreme  dilatation  of 
the  stomach,  the  almost  exclusive  use  of  dry  food 
( Diet  List  No.  2  )  and  well-disintegrated  foods  ( Diet 
List  No.  7 )  is  required,  for  a  few  weeks  at  least. 

Lastly  may  be  mentioned  the  use  of  an  intestinal 
antiseptic  as  a  means  of  preventing  the  development  of 
germs  and  the  formation  of  the  poisons  which  are  the 
real  cause  of  this  disease.  One  of  the  very  best  of 
these  is  vegetable  charcoal,  preferably  charcoal  made 
from  cereals  (4-7,  4-8).  The  addition  of  a  small  pro- 
portion of  sulphur  increases  the  efficiency  of  the 
charcoal.  The  writer  has  for  many  years  employed  a 
mixture  of  this  sort,  which  is  manufactured  by  the 
Modern  Medicine  Company,  Battle  Creek,  Mich. 
(U.  S.  A.),  and  put  up  in  the  convenient  form  of  very 


200  THE    STOMACH. 

palatable  tablets  (4-9).  Two  or  three  of  these  taken 
after  each  meal  aid  the  stomach  in  preventing  the 
action  of  germs,  and  at  the  same  time  so  act  upon  the 
bowels  as  to  prevent  constipation.  I  know  of  no 
remedy  so  valuable  in  the  treatment  of  this  class  of 
cases,  and,  in  fact,  all  cases  arising  from  septic  or  foul 
conditions  of  the  stomach  and  bowels. 

Regularity  of  the  bowels  should  be  established  by 
the  use  of  coarse  food  like  granose  (Diet  List  No.  25 ) 
and  other  whole-grain  preparations,  and  by  the  use  of 
the  graduated  enema,  and  other  measures  suggested 
elsewhere  in  this  work  (  see  .page  279).  Lavage  should 
be  employed  once  or  twice  a  week  in  cases  of  extreme 
dilatation  of  the  stomach,  or  when  fermentation  or 
considerable  quantities  of  mucus  are  found  present  by 
an  examination  of  the  stomach  fluid.  The  charcoal 
tablets  (4-9)  and  lavage  should  be  employed  until  the 
tongue  becomes  clean. 

Swedish  movements  (40),  massage  of  the  stomach 
and  abdomen  (29,  31),  daily  replacement  of  the  ab- 
dominal viscera  (32,  33),  with  general  massage  (36), 
are  measures  of  great  value  in  cases  of  migraine. 

Nervous  Apoplexy. —  This  is  another  condition 
dependent  upon  a  disturbance  of  the  abdominal  sympa- 
thetic, the  symptoms  of  which  so  closely  resemble 
those  of  apoplexy  that  the  person  suffering  from  it 
sometimes  lives  in  almost  constant  dread  of  death  from 
paralysis  as  a  result  of  cerebral  apoplexy.  The  sub- 
jects of  nervous  apoplexy  complain  more  or  less 
habitually  of  giddiness,  especially  after  eating,  double 
vision,  scintillations  before  the  eyes,  sudden  loss  of 
vision,  sudden  change  of  color  in  surrounding  objects, 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  201 

everything  appearing  green,  blue,  or  red,  as  the 
case  may  be,  and  occasionally  sudden  loss  of  con- 
sciousness. The  writer  has  had  several  cases  under  his 
care  in  which  these  symptoms  were  very  pronounced, 
the  patients  often  being  brought  in  from  the  porches  or 
corridors,  where  suddenly,  in  the  midst  of  a  conversa- 
tion, they  had  fallen  to  the  floor  insensible.  Attacks 
of  nervous  apoplexy  are  frequently  induced  by  fright 
or  some  sudden,  strong  emotion,  or  even  by  a  loud 
sound. 

Treatment. —  In  the  treatment  of  these  cases  I 
have  sometimes  seen  the  most  remarkable  results  fol- 
low the  application  of  the  abdominal  supporter  (Fig. 
40),  whereby  the  strained  and  irritated  sympathetic 
nerves,  which  are  always  extremely  sensitive  in  these 
cases,  were  afforded  relief  by  the  support  of  the  pro- 
lapsed stomach,  bowels,  or  other  viscera.  The  moist 
abdominal  bandage  worn  at  night,  fomentations  (10)  to 
the  spine  in  the  morning,  followed  by  a  cool  sponge 
bath  (1),  massage  (31,  36),  Swedish  movements  (41), 
and,  if  possible,  the  application  of  galvanic  electricity 
to  the  spine  and  abdomen  (69),  are  the  most  efficient 
measures  of  treatment. 

The  diet  should  be  strictly  aseptic  (Diet  List  No.  1), 
and  should  in  all  particulars  be  the  same  as  that  recom- 
mended for  nervous  headache.  When  the  stomach 
is  considerably  dilated,  lavage  should  be  employed 
once  or  twice  a  week,  until  the  tongue,  which  is 
always  coated,  becomes  clean.  The  bowels  should 
be  thoroughly  and  regularly  evacuated.  Constipation 
should  be  combated  by  the  measures  elsewhere  recom- 
mended in  this  work.  Antiseptic  charcoal  tablets  (49), 


202  THE    STOMACH. 

as  recommended  for  migraine,  should  also  be  used  in 
this  disease,  two  or  three  to  be  taken  after  each  meal. 
In  both  migraine  and  nervous  apoplexy,  it  is  sometimes 
necessary  to  use  some  intestinal  antiseptic  habitually, 
on  account  of  the  inability  of  the  gastric  juice  to 
thoroughly  disinfect  and  preserve  the  contents  of  the 
stomach  during  digestion. 

For  the  immediate  relief  of  an  attack  of  nervous 
apoplexy,  employ  the  following  measures  :  Put  the 
patient  to  bed  in  a  quiet  room,  excluding  the  light  and 
all  sources  of  excitement.  Apply  fomentations  (10, 11) 
over  the  stomach  and  abdomen  ;  administer  an  enema 
(22)  if  the  bowels  are  constipated  ;  apply  a  wet  girdle 
(9),  and  make  hot  or  cold  applications  to  the  head 
when  indicated.  If  the  head  is  cold  and  the  face  pale, 
hot  applications  should  be  made  ;  if  the  head  is  hot, 
hot  or  alternate  hot  and  cold  sponging  of  the  spine  (18), 
with  cold  applications  to  the  head. 

Disturbance  of  the  Circulation. —  Various 
disturbances  of  the  circulation  are  common  in  dys- 
pepsia. Coldness  of  the  hands  and  feet,  or  the  op- 
posite condition,  especially  at  night,  accompanied  by 
an  aggravated  burning  sensation  ;  unnatural  heat  in 
the  head,  often  accompanied  by  fulness  of  the  veins 
of  the  forehead  and  neck,  showing  intense  congestion  ; 
palpitation  of  the  heart,  especially  occasioned  by  excite- 
ment of  any  kind,  and  sometimes  coming  on  suddenly 
without  apparent  cause ;  intermittent  action  of  the  heart, 
with  sudden  sensations  as  of  stopping,  causing  the  pa- 
tient to  apprehend  impending  death  ;  throbbing  of 
the  arteries  in  various  parts  of  the  body,  this  being 
especially  noticeable  in  irritable  conditions  of  the  stom- 


SYMPTOMATIC    TREATMENT    OF   INDIGESTION.          203 

ach,  which  are  often  accompanied  by  strong  pulsation 
of  the  aorta,  felt  at  the  pit  of  the  stomach  or  lower 
in  the  abdomen;  sudden  flushing  of  the  face,  with  or 
without  any  slight  mental  excitement, — these  are  the 
most  common  symptoms  of  this  condition,  some  of 
which  often  occasion  no  little  uneasiness  on  the  part 
of  the  patient  by  exciting  fears  of  organic  disease  of 
the  heart,  aneurism,  or  some  other  serious  malady, 
which  he  thinks  may  end  his  life  at  any  moment. 

Treatment. — ' 4  General  Tonic  Treatment ' '  ( see  page 
333),  beginning  with  very  gentle  measures  and  pro- 
gressing gradually,  is  one  of  the  most  effective  means 
for  relief  of  disturbances  of  the  circulation.  For  tem- 
porary relief,  hot  or  hot  and  cold  applications  may  be 
made  to  the  feet  and  legs,  and  prolonged  cold  appli- 
cations to  the  parts  which  are  excessively  hot.  Cold 
should  be  applied  over  the  heart  in  cases  of  palpita- 
tion, and  such  measures  employed  as  have  been  else 
where  recommended  for  relief  of  reflex  symptoms  due 
to  an  irritable  condition  of  the  abdominal  sympathetic, 
as  indicated  by  uneasiness  at  the  stomach  and  pain  in 
the  region  of  the  umbilicus  ( see  page  193 ). 

Nocturnal  Asthma  of  Indigestion. —  In  rare 
cases  the  disturbance  of  the  abdominal  sympathetic  is 
so  great,  on  account  of  the  formation  of  poisons  in  the 
stomach  and  bowels,  and  the  failure  of  the  liver  to 
destroy  them  or  the  kidneys  to  eliminate  them,  that  the 
patient  becomes  the  subject  of  dyspnea,  or  difficulty  in 
breathing,  of  the  most  distressing  character.  The 
attacks  usually  come  on  about  midnight, —  often  be- 
fore, but  rarely  later.  The  patient  wakes  suddenly 
from  sleep  to  find  himself  sitting  upright  in  bed, 


204  THE    STOMACH. 

gasping  for  breath,  and  expecting  every  moment  to 
breathe  his  last.  These  paroxysms  are  often  ex- 
tremely distressing,  and  not  easy  to  relieve  except  by 
the  use  of  the  stomach-tube,  which  usually  quickly  cuts 
short  the  attack.  A  large  hot  enema  is  often  of  value 
in  these  cases.  The  reason  for  the  occurrence  of  this 
attack  in  the  night  is  probably  the  lessened  activity  of 
the  kidneys  during  sleep.  During  the  daytime  the 
poisons  are  eliminated  with  sufficient  rapidity  to  pre- 
vent serious  injury  ;  but  the  action  of  the  kidneys  being 
diminished  during  sleep,  the  poisons  accumulate  in 
such  quantities  as  to  produce  the  symptoms  referred  to. 
Those  thus  afflicted  often  experience  relief  after  expel- 
ling a  quantity  of  gas  from  the  stomach.  Eating  sup- 
pers is  also  a  cause  of  these  attacks.  The  delay  in  the 
digestive  process  occasioned  by  sleep  gives  rise  to  fer- 
mentations and  decompositions,  to  which  the  poisons 
above  referred  to  are  due. 

Treatment. —  An  aseptic  dietary  (Diet  List  No.  1 ), 
from  which  flesh  food  of  every  description,  including 
fish,  oysters,  etc.,  is  strictly  excluded,  is  indispensable 
to  recovery  in  these  cases.  Cheese  must  also  be 
prohibited.  The  most  prompt  relief  is  occasioned  by 
a  diet  of  kumyss,  kumyzoon,  or  buttermilk  ( Diet  List 
No.  25  ).  In  many  instances  a  milk  diet  is  sufficient, 
but  in  cases  of  dilatation  of  the  stomach,  milk  is  not 
suitable,  hence  buttermilk  or  kumyzoon  is  to  be 
preferred.  From  two  to  three  quarts  of  buttermilk 
should  be  taken  daily.  No  other  food  but  buttermilk 
or  kumyzoon  should  be  taken  in  severe  cases,  at  least 
for  a  few  days  after  an  attack.  After  three  or  four 
days,  granose  (Diet  List  No.  25)  and  cereal  foods. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.          205 

with  fruits,  may  be  used,  but  vegetables  must  still  be 
avoided.  A  large  hot  enema  should  be  taken  daily, 
and  the  patient  should  take  as  much  exercise  out-of- 
doors  as  possible.  A  short  sweating  bath  will  aid  in 
the  elimination  of  the -poisons,  but  the  hot  bath  should 
be  followed  by  a  cool  shower,  wet- sheet  rubbing,  or 
sponge  bath,  as  a  skin  or  heart  tonic.  A  hot  and  cold 
full  bath  (21)  is  a  most  excellent  measure  for  these 
cases.  Antiseptic  charcoal  tablets  (4-9)  should  be  habit- 
ually used  in  these  cases,  three  or  four  being  taken 
after  each  meal.  It  is  probable  that  nervous  or  es- 
sential asthma  is  always  due  to  poisoning  of  the  nerve 
centers  by  substances  generated  by  germs  in  the  ali- 
mentary canal,  and  absorbed  into  the  circulation. 

"Stomach  Cough."-— This  popular  term  has 
really  more  significance  than  many  physicians  are  ac- 
customed to  allow.  It  is  a  very  common  observation 
that  the  stomach  and  lungs  sympathetically  affect  each 
other.  Most  cases  of  consumption  and  chronic  bron- 
chitis are  accompanied  by  stomach  disorder  ;  and,  on 
the  other  hand,  there  are  many  cases  in  which  dyspep- 
tic conditions  are  accompanied  by  a  troublesome  cough, 
usually  of  a  dry,  hacking  character,  without  expectora- 
tion. In  not  a  few  instances  of  this  kind  the  cough  is 
due  to  an  elongated  palate,  or  to  congestion  of  the 
pharynx.  Most  of  the  remarkable  cures  of  consump- 
tion by  drugs  are  cases  of  this  nature. 

It  must  not  be  supposed,  however,  that  every  hack- 
ing cough  is  due  to  disease  of  the  stomach.  Many  real 
consumptives  make  the  mistake  of  thinking  that  their 
cough  is  wholly  due  to  the  stomach,  and  by  procrasti- 
nation lose  their  only  chance  for  recovery.  A  cough 


206  THE    STOMACH. 

accompanied  by  copious  expectoration,  or  by  a  rapid 
pulse  and  night  sweats,  is  rarely  a  ' '  stomach  cough. ' ' 
Serious  disturbance  of  digestion  is  present,  however, 
in  nearly  all  cases  of  consumption.  In  fact,  as  a  rule, 
failure  of  digestion  precedes  consumption  in  nearly  all 
cases ;  hence  in  most  cases  of  cough,  except  those  in 
which  the  symptom  is  due  to  an  acute  cold,  special  at- 
tention must  be  given  to  the  condition  of  the  stomach. 

Difficulty  of  breathing  and  a  sense  of  suffocation 
are  among  the  symptoms  of  dyspepsia  in  which  the 
lungs  are  involved.  The  difficulty  may  arise  from 
pressure  against  the  diaphragm  by  a  distended  stomach, 
or  through  nervous  influence. 

Treatment. —  In  these  cases,  the  cough  will  be  per- 
manently relieved  only  when  the  digestive  disorder  is 
cured.  Temporary  relief  may  be  obtained  by  the  use 
of  the  Perfection  Yaporizer  (59,  60).  "  General  Tonic 
Treatment "  (see  page  333)  and  such  other  measures  as 
are  indicated  by  the  symptoms  of  indigestion  which 
may  be  present,  must  be  perse veringly  employed.  In 
cases  of  chronic  cough,  the  vaporizer  should  be  used 
several  times  a  day.  Temporary  relief  may  be  occa- 
sioned by  gargling  hot  water  in  the  throat  for  five  to 
ten  minutes  two  or  three  times  a  day.  This  is  also 
a  good  curative  means.  Another  excellent  measure  is 
the  throat  pack,  applied  thus  :  First  place  on  the  throat 
a  cotton  bandage  consisting  of  several  thicknesses  of 
cloth  wrung  dry  from  cold  water,  and  of  sufficient 
length  to  extend  around  the  throat.  Cover  this  with 
several  folds  of  flannel  cloth  of  sufficient  width  to 
extend  an  inch  or  two  over  each  side  of  the  moist  band- 
age, wrapping  as  tightly  as  possible  without  interfer- 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  207 

ing  with  breathing.  This  application  should  be  made 
at  bedtime.  On  rising  in  the  morning,  remove  the 
bandage,  bathe  the  throat  and  chest  with  cold  water, 
and  apply  a  dry  flannel  bandage  to  be  worn  during  the 
day.  The  persistent  use  of  this  measure  is  one  of  the 
most  effective  means  of  relieving  chronic  irritation  of 
the  throat.  In  many  cases  a  diseased  condition  of  the 
tonsils  or  of  the  posterior  portion  of  the  nasal  cavity 
is  present,  and  requires  proper  treatment  by  a  specialist. 

Nervous  Symptoms. —  Most  of  the  symptoms 
thus  far  mentioned  have  related  directly  to  the  digest- 
ive organs  ;  but  still  other  symptoms  of  importance 
remain  to  be  noticed,  which  may  be  termed  ' '  nervous 
symptoms,"  as  they  are  indirectly  occasioned  by  ab- 
normal conditions  of  the  stomach  and  bowels.  These 
symptoms,  although  they  really  arise  wholly  from  dis- 
turbances of  digestion,  are  often  supposed  to  be  in- 
dications of  distinct  and  serious  diseases  of  the  nervous 
system.  There  is  no  doubt  that  faulty  digestion  is 
one  great  cause  of  nervous  disorders,  owing  to  the 
fact  mentioned,  symptoms  at  first  temporary  becoming 
chronic,  and  functional  disturbances  giving  rise  to 
organic  diseases. 

The  nervous  disorders  which  accompany  dyspepsia 
are  due  to  four  causes  :  (1)  To  sympathetic  disturbance 
of  function,  through  the  nervous  connections  of  the 
stomach  ;  (2)  to  impaired  nutrition  of .  the  nervous  sys- 
tem, defective  digestion  occasioning  a  poor  quality  of 
blood  ;  (3)  to  the  presence  in  the  blood  of  the  products 
of  indigestion,  imperfectly  elaborated  food,  acetic  and 
butyric  acids,  and  other  poisons  resulting  from  the 
action  of  germs  ;  (4)  to  retention  of  the  excretions,  ow- 
14 


208  THE    STOMACH. 

ing  to  the  inactive  condition  of  the  liver,  skin,  and 
bowels,  resulting  from  impaired  nutrition. 

The  injurious  elements  mentioned,  coming  in  con- 
tact with  delicate  nerves  already  weakened  by  impaired 
nutrition,  increase  their  irritability,  and  occasion  disor- 
dered actions  of  almost  every  conceivable  variety, 
from  the  slightest  degree  of  mental  disturbance,  as 
shown  in  the  confusion  of  thought  observed  by  the  dys- 
peptic student  or  the  forgetfulness  of  engagements  by 
the  business  man,  to  complete  loss  of  mental  control, 
even  actual  insanity  ;  and  from  the  slight  nervousness 
familiarly  known  as  "fidgets,"  to  the  most  alarming 
convulsive  action,  as  in  epilepsy  and  hysteria. 

Treatment. — The  symptoms  referred  to  in  the  above 
paragraph  should  receive  prompt  and  efficient  attention, 
as  they  may  be  the  beginning  of  grave  nervous  or  men- 
tal disorders.  The  treatment  most  generally  required 
is  that  indicated  for  slow  digestion  ( see  page  245 ). 
The  coloclyster  (23)  or  a  laxative  enema  (25)  not  in- 
frequently dissipates  a  distressing  headache  almost  in- 
stantly. 

Nervousness. —  Many  dyspeptics  suffer  more  or 
less  with  an  indescribable  uneasiness,  sometimes  termed 
"fidgets."  The  limbs  are  chiefly  affected.  The  pa- 
tient finds  it  impossible  to  sit  still.  The  lower  limbs, 
especially,  are  kept  in  almost  constant  motion.  Such 
persons  find  the  confinement  of  sitting  in  church  almost 
unendurable.  This  difficulty  is  especially  troublesome 
in  the  afternoon  and  at  night.  It  is  often  accompanied 
by  peculiar  sensations  in  the  limbs,  especially  when  sit- 
ting or  lying,  as  "crawling,"  "prickling,"  "numb- 
ness," etc.,  which  are  sometimes  thought  to  indicate  a 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  209 

tendency  to  paralysis,  but  are  merely  signs  of  a  weak- 
ened circulation  and  badly  nourished  nerves. 

An  allied  and  very  singular  sensation  is  that  of 
motion.  The  patient,  if  very  nervous, —  and  this  is 
especially  the  case  with  young  women, — will  often 
complain  of  feeling  as  though  being  carried  involun- 
tarily to  different  parts  of  the  room,  as  from  one  corner 
to  another,  to  the  ceiling,  to  the  window,  or  even  into 
another  room.  Patients  sometimes  complain,  also,  of 
feeling  as  though  some  portion  of  the  body  were  larger 
than  natural  ;  as,  when  lying  down,  the  sensation  will 
be  that  a  limb,  or  a  hand,  or  the  head  is  immensely 
large.  The  delusion  vanishes,  however,  upon  the  pa- 
tient's attempting  to  move  the  particular  part  affected. 

Treatment. — Hot  and  cold  sponging  of  the  spine 
daily  (18),  fomentation  (10)  over  the  abdomen  at  night, 
followed  by  the  moist  abdominal  bandage  (9)  to  be 
worn  during  the  night,  the  cool  morning  sponge  bath 
(1),  and  the  abdominal  supporter  (45)  are  the  best 
means  of  palliation  in  these  cases  ;  but  a  thorough 
course  of  treatment  and  training  at  a  well-equipped 
and  scientifically  conducted  sanitarium  is  essential  for 
a  cure  in  most  cases.  General  nutritive  (page  331)  or 
tonic  treatment  (page  333)  should  be  employed. 

Disturbances  of  Sight,  Hearing,  etc. — Noth- 
ing is  more  common  in  this  disease  than  disturbances 
of  vision  and  of  the  various  other  special  senses.  Dim- 
ness of  vision,  deafness,  ringing  in  the  ears,  extreme 
sensitiveness  to  noise  and  also  to  light,  occur  in  many 
cases.  Not  infrequently  the  patient  sees  imaginary 
forms  of  various  sorts.  Sometimes  the  intolerance  of 
light  is  so  great  that  the  patient  wishes  to  remain  in  a 


210  THE    STOMACH. 

dark  room.  This  is  more  common  in  women  than  in 
men.  Often  this  extreme  degree  of  apparent  sensitive- 
ness is  more  imaginary  than  real.  The  appearance  of 
black  or  bright  spots  of  various  shapes  and  sizes,  espe- 
cially noted  when  stooping  over,  is  another  common 
symptom.  Unnatural  thirst,  perversions  of  taste,  pe- 
culiar sensitiveness  of  various  parts  of  the  body,  are 
also  symptoms  worthy  of  notice. 

Treatment. —  In  extreme  cases,  the  "Rest-Cure" 
(page  329),  followed  by  progressive  application  of 
nutritive  and  tonic  treatment  ( pages  331  and  333 ),  is 
required  in  addition  to  the  application  of  such  palliative 
measures  as  may  be  indicated  by  the  general  and  local 
symptoms  presented. 

Nervous  Diseases.— Functional  nervous  disor- 
ders, as  hysteria,  epilepsy,  and  even  temporary  pa- 
ralysis, often  originate  in  dyspepsia.  Dr.  Chambers, 
an  eminent  English  physician,  asserts  that  nine  cases 
out  of  ten  of  hysteria  are  due  to  indigestion.  This 
statement  I  have  found  abundantly  confirmed  by  my 
own  observation.  In  the  treatment  of  epilepsy,  I 
have  observed  in  many  cases,  tenderness  at  the 
pit  of  the  stomach,  and  a  foul  tongue.  In  some  in- 
stances, no  doubt,  the  stomach  disease  is  secondary  ; 
but  many  times,  at  least,  I  believe  that  the  latter 
difficulty  is  the  primary  affection.  In  many  cases 
the  remedy  given  to  cure  the  disease  is  of  a  character 
to  defeat  the  end  desired,  by  deranging  the  stomach. 
The  long-continued  use  of  bromides  is  certain  to  derange 
the  digestive  organs,  as  this  drug  lessens  the  activity  of 
the  glands  of  the  stomach.  When  bromides  are  used, 
a  good  intestinal  antiseptic  should  be  constantly  em- 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  211 

ployed,  as  a  means  of  preventing  the  fermentation  of 
the  food  substances  through  the  action  of  microbes 
which  are  left  to.  develop  in  consequence  of  a  deficient 
supply  of  hydrochloric  acid  in  the  gastric  juice.  Anti- 
septic charcoal  tablets  are  most  suitable  for  this  pur- 
pose (49). 

If  the  tongue  is  coated,  the  treatment  recommended 
for  septic  indigestion  (page  251)  should  be  employed. 
Careful  examination  should  be  made  in  relation  to  the 
condition  of  the  stomach  as  regards  dilatation  (page 
215).  If  possible,  a  test  meal  should  be  given  and  the 
stomach  fluid  examined,  as  much  light  is  by  this  means 
often  thrown  upon  the  nature  of  the  disease  presented 
(page  m). 

Unusual  Drowsiness. — This  symptom  occurs 
most  often  after  eating,  though  it  is  sometimes  almost 
continuous.  An  hour  or  two  after  eating,  the  patient 
feels  an  almost  irresistible  desire  to  sleep.  The  sense 
of  weariness  and  lassitude  is  sometimes  so  great  that  it 
is  with  difficulty  that  the  person  so  affected  can  be  in- 
duced to  make  an  attempt  to  exercise.  If  he  does  so, 
however,  he  feels  much  better  than  if  he  yields  to  his 
desire  to  sleep.  Exercise  dispels  the  exhausted  feel- 
ing, which  is  not  fatigue  ;  while  if  the  patient  allows 
himself  to  sleep,  he  awakes  unrefreshed,  and  feeling 
really  worse  than  when  he  lay  down.  In  these  cases, 
drowsiness  is  due  to  the  development  of  poisonous 
substances  through  the  action  of  germs  upon  the  food, 
and  their  absorption  into  the  system. 

Treatment.  —  This  symptom,  often  very  trouble- 
some, is  frequently  due  to  overeating,  and  is  promptly 
relieved  by  eating  a  smaller  quantity  of  food.  Rapid 


212  THE    STOMACH. 

eating  is  another  common  cause.  The  hot  and  cold 
trunk  pack  is  a  valuable  measure  of  treatment,  also 
fomentations  to  the  abdomen,  the  moist  abdominal 
bandage  at  night,  and  plenty  of  outdoor  exercise. 
The  measures  recommended  for  "  Simple  Dyspepsia, " 
or  slow  digestion  ( page  245  ),  should  be  employed.  For 
temporary  relief  the  patient  should  drink  one  or  two 
glasses  of  hot  water,  and  practice  deep-breathing  ex- 
ercises (38). 

Sleeplessness. —  This  condition,  quite  the  oppo- 
site of  the  preceding,  is  equally  common,  and  often  ex- 
ists in  the  same  individual,  the  person  being  very 
sleepy  soon  after  eating,  but  wakeful  at  night.  The 
patient  is  not  kept  awake  by  pain,  but  by  simple 
nervousness,  by  a  sense  of  weight  at  the  stomach,  by 
morbid  anxiety  or  fears,  by  burning  of  the  feet  and 
hands,  or  some  similar  cause.  If  sleep  comes,  it  is 
not  sound.  There  are  troubled  dreams,  and  the  per- 
son awakes  in  the  morning  unrested  and  unrefreshed. 
These  patients  usually  feel  best  in  the  afternoon  and 
early  evening. 

In  most  cases  of  chronic  insomnia  the  patient  will 
be  found  to  present  a  very  foul  tongue.  There  is 
often  dilatation  of  the  stomach,  and  generally  many 
other  symptoms  pointing  to  disturbed  digestion  as  the 
real  cause  of  the  sleeplessness. 

Treatment. —  Lavage  of  the  stomach,  the  employ- 
ment of  a  strictly  aseptic  dietary  (Diet  List  No.  1 ), — 
it  may  be  necessary  to  discard  even  milk  if  the  stomach 
is  dilated, —  the  use  of  antiseptic  charcoal  tablets  (4-9), 
fomentations  to  the  abdomen  at  night,  the  wet  girdle  (9) 
worn  during  the  night,  and  "  General  Tonic  Treatment " 


SYMPTOMATIC   TREATMENT   OF   INDIGESTION.          213 

( page  333 )  are  the  measures  specially  indicated.  The 
sleeplessness  is  the  result  of  the  circulation  in  the 
blood  of  substances  of  an  irritating  or  exciting  char- 
acter. An  aseptic  dietary  prevents  the  development  of 
these  poisons,  and  their  elimination  may  be  aided  by 
copious  water-drinking,  exercise  (37)  in  the  open  air 
sufficient  to  cause  perspiration,  breathing  exercises  (38), 
a  light  sweating  bath  once  or  twice  a  week  (16,  17), 
fomentations  over  the  stomach  and  liver  (10),  sun  or 
electric- light  baths  (15),  whereby  the  skin  is  stimu- 
lated, etc.  The  Natural  Abdominal  Supporter  (4-5), 
in  cases  which  require  it,  affords  great  relief. 

This    most    annoying   and  exhausting   symptom  — 
sleeplessness  —  also  requires  attention  to  the  following 
suggestions  :  - 

1.  Retire  early,  having  taken,  an  hour  or  so  before, 
sufficient  muscular  exercise  to  induce  slight  weariness. 

2.  Eat  nothing  within  four  hours  of  bedtime.      Go- 
ing to  bed  without  supper  is  perhaps  the  best   of    all 
remedies  for  sleeplessness.      If  there  is  a  faint  feeling 
at   the  stomach,   drink  half  a  glass  of  hot  water.     If 
this  does  not  suffice,  a  mellow,  sweet  or  subacid  apple 
may  be  taken  an  hour  before  retiring,  unless  fruit  oc- 
casions pain  or  acidity,  in  which  case  one  or  two  tablets 
of  bromose  may  be  substituted. 

3.  If  feverish,  the  skin  being  hot  and  dry,  take  a 
light  hand  bath  with  tepid  water  upon  retiring. 

4.  If  the  feet  and  hands  are  cold,  employ  the  means 
elsewhere  suggested  for  this  condition  (page  191). 

5.  Sleep  in  a  cool  room,  taking  care  to  see  that  the 
bedding   is   well    aired   and  dry,   and   the   room   well 
ventilated. 


214  THE    STOMACH. 

6.  When  nervousness  causes  loss  of  sleep,  there 
are  various  methods  of  inducing  slumber,  one  of  the 
most  efficient  being  slow,  deep,  and  steady  breathing. 
By  this  means  the  lungs  are  filled  with  blood,  and  the 
brain  is  thus  relieved  of  the  congestion  which  causes 
wakefulness. 

7.  When  the  head  feels  cold,  the  indication  is  that 
there  is  not  enough  blood  in  the  brain,  and  the  head 
should  be  protected  by  flannel  coverings.     If  the  head 
is  hot,  a  cloth  moistened  in  cool  or  cold  water  may  be 
applied,  the  hair  being  first  wet. 

8.  In  case  the  head  is  hot  and  full  of  blood,  sleep 
may  often  be  induced  by  raising  the  head  of  the  bed  six 
inches  or  more  above  the  level  of  the  foot.      If  the  face 
is  pale  and  the  head  cold,  the  foot  instead  of  the  head 
of  the  bed  may  be  raised. 

9.  For  sound  sleep,  the  sleeping-room  should  not 
be  too  warm,  and  the  patient  should  not  be  too  warmly 
covered  in  bed. 

10.  Avoid  exciting  conversation  or  reading  shortly 
before  retiring. 

Mental  Disorders. — Until  of  late  years  it  was 
not  known  that  dyspepsia  could  be  recognized  by  the 
mental  and  nervous  symptoms  alone  ;  and  even  yet  the 
fact  is  not  as  well  understood  as  it  should  be.  It  is 
thoroughly  established,  however,  at  the  present  time, 
that  this  is  the  case,  and  also  that  when  the  mental  and 
nervous  symptoms  are  most  prominent,  those  which 
point  directly  to  the  digestive  organs  are  the  fewest 
and  most  obscure.  Hypochondria  has  long  been 
associated  with  indigestion,  though  often  attributed 
to  the  liver.  Students,  clergymen,  and  other  mental 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  215 

workers  who  suffer  from  cerebral  hyperemia,  or  chronic 
congestion  of  the  brain,  are  nearly  always  victims  of 
indigestion,  which  results  in  defective  nutrition  of  the 
nervous  system.  Gloomy  apprehensions,  forebodings, 
peevishness,  perversity  of  disposition,  religious  despair, 
confusion  of  thought,  loss  of  memory,  absent-minded- 
ness, and  many  other  forms  of  mental  disturbance  are 
justly  attributable  to  this  cause,  and  disappear  upon  its 
removal. 

The  failure  on  the  part  of  many  physicians  to 
recognize  this  class  of  cases  has  consigned  many  men 
of  ability  and  influence  to  insane  asylums,  with  no 
hope  of  recovery,  who  might  have  been  saved  to  the 
world,  their  families,  and  themselves  by  a  judiciously 
directed  course  of  treatment.  Hundreds  of  nervous 
women  who  have  had  their  spines  blistered  and  burned 
and  cauterized  for  some  supposed  obscure  nervous 
trouble,  enduring  years  of  torture,  all  without  benefit, 
might  have  been  made  well  by  a  few  months  of  intelli- 
gent treatment  for  impaired  digestion.  A  large  number 
of  both  classes  of  invalids  have  come  under  my  care, 
some  of  whom  had  been  inmates  of  insane  asylums 
for  years  without  recovering,  while  others  had  baffled 
the  skill  of  eminent  neurologists  ;  and  having  seen  a 
large  number  of  these  cases  recover  mental  soundness 
under  rational  treatment  and  with  regulation  of  the  diet 
and  regimen,  I  am  convinced  that  much  more  attention 
should  be  paid  to  this  class  of  dyspeptic  cases.  It  is 
gratifying  to  see  that  particular  attention  is  given  to  this 
matter  in  some  of  the  best-regulated  insane  asylums. 

Dilatation  of  the  Stomach. — This  condition 
is  one  which  has,  until  recently,  been  rarely  recognized. 


THE    STOMACH. 

Ten  or  twelve  years  ago  Glenard,  an  eminent  French 
physician,  called  attention  to  the  frequency  with  which 
both  dilatation  and  prolapse  of  the  stomach  occur.  By 
careful  observation  and  logical  deduction,  Glenard 
showed  that  a  large  share  of  the  most  obstinate  symp- 
toms encountered  in  dyspeptics  is  dependent  upon  a 
disturbance  of  the  functions  of  the  stomach  arising  from 
dilatation  or  prolapse  of  the  organ.  The  principal 
cause  of  prolapse  is  constriction  of  the  waist  by  corsets, 
tight  skirt-bands  in  women,  and  the  wearing  of  belts  in 
men.  In  conjunction  with  dilatation  and  prolapse  of 
the  stomach,  one  or  both  kidnevs  are  frequently  found 
prolapsed,  the  colon  fallen  below  its  normal  position, 
and  not  uncommonly  folded  upon  itself,  and  the  liver 
and  spleen  also  displaced  in  a  downward  direction. 
The  consequences  of  these  displacements  are  far  more 
serious  than  any  other  visceral  displacements  which 
can  occur  in  the  body.  Dislocation  of  the  womb  or 
ovaries  in  women,  or  the  dislocation  of  a  joint  in  either 
sex,  is  a  matter  of  small  consequence  compared  with 
displacement  of  the  stomach,  the  liver,  or  the  colon. 
Space  will  not  here  permit  a  consideration  of  all  the 
symptoms  which  may  grow  out  of  these  displacements. 
Suffice  it  to  say  that  most  of  the  numerous  symptoms 
previously  described  as  observable  in  indigestion  may 
be  the  direct  outcome  of  displacement  or  dilatation  of 
the  stomach,  or  prolapse  of  the  other  organs  of  di- 
gestion. 

In  prolapse  of  the  stomach  and  other  abdominal 
organs,  the  fact  is  in  many  cases  quite  apparent  from 
the  external  form  of  the  body.  The  waist  is  usually 
flat  or  depressed,  and  the  lower  abdomen  excessively 


SYMPTOMATIC    TREATMENT    OF   INDIGESTION.  217 

prominent.  In  addition,  there  is  usually  a  forward 
carriage  of  the  hips,  round  shoulders,  depressed  chest, 
with  undue  prominence  of  the  spine  between  the 
shoulders,  and  forward  carriage  of  the  head.  This 
condition  is  a  prevailing  one  in  women  who  have  worn 
the  ordinary  conventional  dress.  A  very  common 
symptom  of  dilatation  of  the  stomach  is  a  plashing 
sound  heard  in  walking  or  when  rocking  in  a  rocking- 
chair  after  swallowing  a  quantity  of  water  or  other 
fluid.  Some  illustrations  of  cases  of  dilatation  and  pro- 
lapse of  the  stomach  and  other  organs  associated  with 
indigestion,  are  represented  in  Plate  IY,  page  133. 

Treatment. —  In  the  treatment  of  this  condition  the 
most  important  measures  are  :  — 

1.  Sufficient  loosening   of   the    clothing  to  permit 
proper  expansion  of  the  body  at  the  waist,  thus  allow- 
ing the  prolapsed   organs  to  return   to   their   normal 
position.       For   suggestions    respecting   proper   dress, 
which  is  very  essential  to  the  cure   of   indigestion  in 
women,  see  page  123. 

2.  The  support  of  the  lower  abdomen  by  means  of 
the  Natural  Abdominal    Supporter  (45),  whereby  the 
displaced    viscera   are   lifted   up   into   position.       The 
action   of   the   supporter    is   practically   identical  with 
that  of  the  hands  when  used  to  lift  up  the  abdomen,— 
a  practice   to  which  many  such   sufferers  resort  as  a 
means  of  relieving  uncomfortable,   sinking,  dragging, 
and    other   distressing   sensations   experienced   in   the 
lower   abdomen.     The   employment   of   artificial   sup- 
port, however,  is  not  sufficient  to  accomplish  all  that 
needs  to  be  done  in  these  cases.     The  viscera  must  be 
replaced  by  massage  applied  by  a  skilled  masseur  or 


218  THE    STOMACH. 

masseuse  who  has  been  taught  the  normal  position  of 
the  viscera,  and  how  to  distinguish  each  organ  by 
palpation,  and  restore  it  to  its  normal  position.  By 
the  employment  of  massage,  the  abdominal  muscles 
may  also  be  strengthened,  a  dilated  stomach  emptied, 
and  congestion  relieved  (31,  32,  33). 

3.  The  application  of  electricity,  particularly  by  the 
sinusoidal  current,*  to  the  abdominal  muscles,  whereby 
they   may   be   exercised    and    strengthened.     I    have 
found  the  application  of  the  sinusoidal  electrical  cur- 
rent to  the  interior  of  the  stomach,  an  excellent  means 
of  treatment  in  cases  of  dilatation  of  that  organ.     The 
application    is    made   by   passing    a    conducting   wire 
through   a  stomach-tube  introduced   into  the  stomach. 
In  one  case  in  which  every  other  measure  had  failed, 
the  patient  was  in  this  way  rapidly  and  permanently 
benefited  (67,  68). 

4.  Carefully  graduated  exercise,  particularly  manual 
(42)  and  mechanical  Swedish  movements  (page  334), 
which  is  an  important  means  of  developing  the  muscles 
of  the  trunk  in  cases  of  this  class.     Bicycle  riding  and 
boating  are  also  to  be  recommended,  if  employed  intel- 
ligently, and  not  indulged  to  excess  (37). 

5.  An  aseptic  dietary  ( Diet  List  No.   1 )  is  abso- 
lutely essential  in  these  cases,  and  should  be  scrupu- 
lously adhered  to  for  an  indefinite  period.     For  three 
or  four  weeks  the  patient  should  be  confined  strictly  to 
a  dry  diet  (Diet  List  No.  2 ),  no  fluid  whatever  being 
allowed  at  meals  nor  until  five  or  six  hours  after  eating. 

*For  a  description  of  the  Sinusoidal  Current,  discovered  by  the 
author  in  1883,  see  "  The  Graphic  Study  of  Electrical  Currents  in  Rela- 
tion to  Therapeutics,  with  Special  Reference  to  the  Sinusoidal  Current," 
Modern  Medicine  Publishing  Co.,  Battle  Creek,  Mich. 


SYMPTOMATIC    TREATMENT    OF    INDIGESTION.  219 

Indeed,  little  fluid  should  be  taken  into  the  stomach  at 
any  time  in  these  cases.  If  the  patient  is  thirsty,  the 
thirst  may  be  relieved  by  introducing  water  into  the 
bowels  by  means  of  the  enema. 

A  person  suffering  from  dilatation  of  the  stomach 
should  avoid  swallowing  plum  stones  and  cherry  pits. 
The  stomach  of  an  adult  German  was  found,  at  the 
autopsy,  to  contain  nine  hundred  and  twenty  cherry 
pits  and  seventeen  plum  stones,  which  had  been  re- 
tained for  at  least  eight  or  nine  months. 

The  writer  has  succeeded  in  curing  two  cases  of 
exceedingly  bad  prolapse  of  the  stomach  by  a  surgical 
operation.  The  abdomen  was  opened  by  an  incision 
extending  from  the  lower  end  of  the  sternum  to  the 
umbilicus.  The  stomach,  the  lower  border  of  which 
lay  several  inches  below  the  umbilicus  on  the  right 
side,  was  pulled  into  position,  the  lower  border  lifted 
as  high  as  possible,  and  sutured  to  the  median  line  by 
means  of  four  silkworm-gut  sutures,  which  were  left 
buried  in  the  tissues.  A  floating  kidney  was  also 
found  in  one  case,  and  sutured  in  position.  Both 
patients  made  good  recovery.  The  tongue,  which 
had  for  years  been  extremely  foul,  became  clean  in  a 
short  time,  and  other  disturbing  symptoms  which  had 
been  present  for  years  soon  disappeared. 

Another  method  which  has  been  employed  is  the 
enfolding  of  a  portion  of  the  dilated  stomach.  It  is 
said  that  the  enfolded  portion  disappears  in  the  course 
of  time.  Surgical  measures  are  seldom  required,  how- 
ever. I  have  succeeded  in  restoring  the  prolapsed  stom- 
ach to  position  and  greatly  diminishing  the  size  of  a 
dilated  stomach  in  a  great  number  of  cases,  by  purely 


220  THE    STOMACH. 

non-surgical  means.  The  wearing  of  the  abdominal 
supporter  (45)  and  the  development  of  the  abdominal 
muscles  by  special  exercises  (33,  37),  with  the  use  of 
electricity,  are  sufficient  to  accomplish  all  that  is  re- 
quired in  the  majority  of  these  cases.  Persons  having 
once  had  a  dilated  stomach,  however,  must  not  expect 
to  be  so  thoroughly  cured  that  they  can  ignore  a  careful 
regulation  of  the  dietary  with  reference  to  their  con- 
dition. 


TREATMENT  OF  DYSPEPSIA. 


As  dyspepsia  is  not  usually  a  fatal  disease,  thou- 
sands of  people  allow  themselves  to  suffer  from  its 
pains  and  inconveniences  for  years  without  making 
serious  efforts  to  recover.  If  anything  is  done,  it  is 
most  likely  to  be  a  trial  of  some  quack  nostrum  ad- 
vertised on  the  fence  or  heralded  in  the  daily  news- 
paper as  a  "sure  cure"  for  indigestion,  its  merits 
certified  to  by  a  long  list  of  fictitious  or  purchased 
testimonials.  Of  course  every  effort  of  this  sort  makes 
the  disease  worse  in  the  end,  even  though  there  may 
be  apparent  temporary  relief.  The  sufferer  finally 
settles  down  to  the  melancholy  conclusion  that  his 
malady  is  incurable,  and  thus  lives  along  in  a 
wretched  way  until  consumption,  that  dread  disease 
which  often  follows  close  on  the  heels  of  the  hydra- 
headed  malady  we  are  considering,  claims  him  as  a 
victim,  and  ends  his  misery. 

The  importance  of  giving  serious  attention  to  the 
treatment  of  this  disease  is  further  proved  by  the  fact 
that  many  organic  affections  which,  when  once  well 
established,  it  is  impossible  to  cure,  have  their  origin 
in  indigestion.  This  is  undoubtedly  true  of  tuber- 
cular degeneration  of  the  lungs  and  of  other  degen- 
erative changes  in  various  parts  of  the  body.  The 
same  may  also  be  said  of  many  nervous  affections. 
This  accounts,  in  part  at  least,  for  the  almost  constant 

[221] 


222  THE    STOMACH. 

association  of  impaired  digestion  with  consumption 
and  various  organic  affections  of  the  liver,  kidneys, 
and  other  organs.  In  most  of  these  cases,  the  best, 
sometimes  the  only,  hope  of  a  cure  lies  in  the  treat- 
ment and  cure  of  the  digestive  disorder  ;  and,  without 
doubt,  if  this  could  be  accomplished  sufficiently  early, 
many  cases  of  hopeless  organic  disease  of  the  lungs 
and  other  organs  might  be  prevented  altogether. 

The  dyspeptic,  of  all  invalids,  needs  to  enter  upon 
the  work  of  getting  well  with  a  determination  to  suc- 
ceed, and  with  a  resolution  to  do  all  in  his  power  to 
accomplish  that  end.  Though  an  intelligent  physician 
can  do  much,  the  patient  can  do  vastly  more  for  him- 
self than  any  one  can  do  for  him.  Indeed,  he  alone 
can  control  many  of  the  conditions  essential  for  the 
happy  termination  of  his  sufferings.  If  the  dyspeptic 
would  recover,  he  must  seek  carefully  for  each  of  the 
causes  of  his  disease,  and  remove  them.  It  is  of  no 
use  to  hope  for  recovery  without  doing  this.  If  the 
cause  is  in  the  manner  of  eating,  let  him  take  care  to 
eat  properly.  If  he  has  erred  in  eating  too  much,  or 
in  eating  improper  articles  of  food,  let  him  make  a 
thorough  reform  in  this  regard.  If  the  difficulty  has 
been  in  overwork,  too  much  anxiety,  too  little  time  for 
digestion,  or  too  sedentary  habits,  he  must  get  away 
from  his  care,  his  business,  his  writing-desk,  and  seek 
health  in  outdoor  exercise,  with  happy,  cheerful  asso- 
ciations. The  careworn,  burdened  mother  must  have 
relief  from  the  tedium  of  her  routine  life.  A  journey, 
a  visit  to  a  friend,  or  some  other  means  of  diversion 
must  be  adopted.  Whatever  the  cause  has  been,  it 
must  be  removed.  No  medicine  known,  no  matter  how 


TREATMENT    OF    DYSPEPSIA.  223 

potent  nor  how  skilful  its  administration,  can  antidote 
the  effects  of  the  transgression  of  physical  laws.  Na- 
ture is  inexorable.  She  demands  obedience,  and  will 
not  be  put  off  with  any  subterfuge. 

The  dyspeptic  must  also  remember  that  it  is  not 
only  his  stomach  which  is  diseased,  but  that  every  cell 
and  fiber  of  his  body  is  more  or  less  injmred  by  the  fail- 
ure of  the  stomach  to  supply  proper  nourishment  for 
rebuilding  the  tissues,  or  by  poisoning  from  the  products 
of  fermentation  and  decay  which  have  been  absorbed 
from  the  dilated  or  prolapsed  and  sluggish  stomach. 

It  must  not  be  expected  that  recovery  from  the  con- 
sequences of  a  disease  of  many  years'  standing  can  be 
effected  in  a  few  weeks.  Getting  well  is  a  process  of 
growth,  as  much  as  the  raising  of  a  crop  of  corn  or 
the  development  of  a  tree.  The  diseased  stomach  must 
be  grown  out  of  its  vicious  ways  and  into  a  healthy  con- 
dition, under  the  influence  of  correct  habits  of  eating 
and  appropriate  conditions  of  regimen  and  treatment. 
Many  symptoms  which  have  been  long  established  will 
persist  for  some  time  after  proper  treatment  has  been 
established  ;  but  this  fact  must  not  discourage  its  con- 
tinuance. The  patient  should  weigh  himself  at  the 
beginning  of  treatment,  and  thereafter  at  least  once  a 
week.  Loss  of  flesh  for  the  first  few  weeks  must  not 
be  a  cause  of  discouragement,  however,  as  it  is  a  fre- 
quent occurrence.  A  gain  in  flesh  may,  however,  be 
regarded  as  one  of  the  most  promising  symptoms  in 
cases  in  which  any  considerable  degree  of  emaciation 
has  existed. 

It  must  not  be  supposed  that  any  one  plan  will  ac- 
complish the  result  desired  in  all  cases.  There  are 
15 


THE   STOMACH. 

various  forms  of  dyspepsia,  each  of  which  requires 
special  management,  though  the  general  principles  laid 
down  apply  to  all  classes  of  the  disease. 

Diet  and  Regimen. —  In  the  treatment  of  this  dis- 
ease, proper  diet  and  regimen  are  of  first  importance. 
'  It  is  necessary,  however,  that  they  should  be  most  care- 
fully adapted  to  the  wants  of  each  individual  case,  as 
nothing  is  truer  than  the  old  adage  that  < '  what  is 
one  man's  meat  is  another's  poison,"  when  referring 
to  cases  of  dyspepsia.  The  common  plan  of  recom- 
mending some  special  dietary  to  all  dyspeptics  indis- 
criminately is  a  most  pernicious  one.  We  hear  much 
of  the  " grape  cure, "  the  "  beef  cure,"  the  "fat  cure," 
the  "cod-liver-oil  cure,"  the  "milk  cure,"  and  sundry 
other  special  diet  cures  of  dyspepsia,  as  well  as  the 
"vegetarian  cure."  Each  of  these  diets  may  be  of 
service  to  some  special  case,  but  all  are  totally  unfitted 
for  all  cases  alike. 

It  is  not  an  easy  matter  to  induce  individuals  suffer- 
ing with  dyspepsia  to  deny  the  demands  of  appetite. 
In  many  cases  the  appetite  is  perverted,  and  the  will  is 
so  weakened  by  long-continued  disease  that  the  patient 
loses  self-control,  and  thus  himself  constitutes  the  most 
difficult  obstacle  in  the  way  of  his  recovery.  If  a  cure 
is  expected,  the  directions  given  must  be  followed  im- 
plicitly. In  no  other  way  can  a  confirmed  dyspeptic 
hope  for  recovery.  All  but  one  or  two  requirements 
may  be  carried  out,  yet  failure  in  one  particular  be 
sufficient  to  make  all  other  efforts  useless. 

Dietetic  Rules. — Although  there  is  no  such  thing 
as  a  universal  diet  for  dyspeptics,  there  are  certain  arti- 
cles which  must  be  discarded  by  all  persona  who  have 


TREATMENT    OF    DYSPEPSIA.  225 

weak  digestion,  and  certain  dietetic  rules  which  must 
be  conformed  to  by  all.  To  the  most  important  of 
these  attention  is  now  called. 

1.  Eat   slowly,  masticating   the   food   very   thor- 
oughly.    The  longer  the  food  remains  in  the  mouth, 
the  less  time  it  will  spend  in  the  stomach. 

2.  In   general,    dyspeptic   stomachs   manage   dry 
food  better  than  that  containing  much  fluid. 

3.  Avoid  drinking  at  meals  ;  at  most,  take  a  few 
sips  of  warm  drink  at  the  close  of  the  meal,  if  the  food 
is  very  dry  in  character. 

4.  Be  careful  to  avoid  excess  in  eating.     Eat  no 
more  than  the  wants  of  the  system  require.     Sometimes 
less  than  is  really  needed  must  be  taken  when  digestion 
is  very  weak.     Strength  depends  not  on  what  is  eaten, 
but  on  what  is  digested. 

5.  Never  take  violent  exercise  of  any  sort,  either 
mental  or  physical,  just  before  or  just  after  a  meal. 

6.  It  is  not  well  to  sleep  immediately  after  eating, 
nor  within  four  hours  of  a  meal. 

7.  Never  eat   more  than  three  times  a  day,  and 
make  the  last  meal  very  light.     For  most  dyspeptics,  as 
well  as  healthy  adults,  two  meals  are  better  than  more. 
The  length  of  time  between  meals  should  not  be  less 
than  seven  hours,  unless  a  special  dietary  is  followed  ; 
8  :  00  A    M.   and    3  :  00  P.    M.   are  suitable  times   for 
meals. 

8.  Never  eat  a  morsel  of  food  between  meals. 

9.  Never  eat  when  very  tired,  whether  exhausted 
from  mental  or  physical  labor. 

10.  Never  eat  when  the  mind  is  worried  or  the  tem- 
per ruffled,  if  possible  to  avoid  doing  so. 


226  THE    STOMACH. 

11.  Eat  only  food  that  is  easy  of  digestion,  avoid- 
ing complicated  and  indigestible  dishes,  and  partaking 
of  few  kinds  at  a  meal.     In  severe  cases  it  is  often  nec- 
essary to  confine  the  diet  for  a  time  to  one  or  two  arti- 
cles of  food  which  are  the  most   easily  digested   and 
assimilated. 

12.  Most  persons  will  do  well  to  discard  the  use  of 
meats,  and  add  to  their  bill  of  fare  an  increased  pro- 
portion in  quantity  and  variety  of  cereal  foods.     The 
foods  manufactured    by   the    Battle    Creek  Sanitarium 
Health  Food  Company,  are  to  be  highly  recommended. 
They  have  been  prepared  especially  for  the  use  of  in- 
valids  with   feeble  digestion,  and    are  just  what  they 
claim  to  be.     The  writer  has  prescribed  them  in  many 
thousands  of  cases,    and  finds  them    indispensable   in 
the  treatment  of  the  hundreds  of   invalids  with   disor- 
dered digestion  who  come  under  his  care  annually. 

As  an  aid  to  the  reader  in  the  selection  of  a  diet 
suitable  to  his  case,  the  following  diet  lists  are  pre- 
sented, which  it  is  hoped  will  be  found  helpful  :  — 

DIET  TABLE5. 

The  following  is  a  list  of  dietaries  which  are  based 
upon  observations  made  in  connection  with  the  exact 
methods  of  analysis  of  stomach  fluids  and  the  study  of 
digestive  disorders,  to  which  reference  has  already 
been  made.  They  have  been  tested  in  the  treatment 
of  many  thousands  of  invalids  at  the  Medical  and 
Surgical  Sanitarium  at  Battle  Creek,  Mich.,  and  have 
proved  highly  satisfactory.  The  made  dishes  called  for 
are  cooked  in  accordance  with  recipes  given  in  ' '  Sci- 


TREATMENT    OF    DYSPEPSIA. 


227 


ence  in  the  Kitchen,"  by  Mrs.  E.  E.  Kellogg,  A.  M., 
published  by  the  Modern  Medicine  Pub.  Co.,  Battle 
Creek,  Mich. 

DIET  LIST  NO.  1.- ASEPTIC  DIETARY. 

Especially  adapted  to  cases  in  which  fermentation  is 
present,  also  in  cases  of  chronic  biliousness,  sick-head- 
ache, jaundice,  Bright' s  disease,  gastric  and  intestinal 
catarrh,  simple  dyspepsia,  most  cases  of  hyperpepsia, 
and  cases  of  hypopepsia  not  of  extreme  degree. 

A.    Sterilized  Foods  Prepared  without  Milk  or  Eggs. 


Peas  purge. 
Lentil  puree. 
Beans  puree. 
Nuts  puree. 
Granose. 
Granola. 


Graham  mush. 
Oatmeal  mush. 
Mixed  mush. 
Gluten  mush. 
Granola  mush. 
Hominy  flakes. 
Oatmeal  blanc-mange. 
Gluten  water  gruel. 
Graham  grits  gruel. 
Corn-meal  gruel. 
Graham  gruel. 
Oatmeal  gruel. 
Split  pea  soup. 
Lentil  soup. 
Green  peas. 

Lentil  toast. 
Granose  brown  bread. 
Zwieback. 


Grapes. 
Eaisins. 
Apples. 


Berries. 

Cherries. 

Currants. 


Macaroni  with  tomato 

sauce. 
Fruit  toast. 
Vegetable  broths. 
Corn  soup. 

GRAINS. 

Barley  gruel. 
Corn-meal. 
Cracked  wheat. 
Boiled  wheat. 
Molded  wheat. 
Pearled  wheat. 
Rolled  wheat. 
Graham  grits. 
Bran  jelly. 
Grain  jelly. 
Jellied  oatmeal. 
Rolled  oats. 
Baked  potato. 
Corn  pulp. 

Crystal  wheat. 

Sticks. 

Crisps. 

FRESH  FRUITS. 

Peaches. 
Oranges. 
Pineapples. 


Bromose. 
Nut  porridge. 
Nut  butter. 
Nut  meal. 
Sterilized  butter. 


Rolled  rye. 

Rice. 

Rice  water. 

Rice  molded. 

Browned  rice. 

Hulled  corn. 

Gluten. 

Grains  of  gold. 

Hominy. 

Popped  Corn. 

Corn  gofio. 

Wheat  gofio. 

Pulp  succotash. 

Kornlet  and  tomato. 

Kornlet. 

Unfermented  breads 
prepared  without 
milk. 


Pears. 

Figs. 

Bananas. 


Melons. 
Dates. 


228  THE    STOMACH. 

FRUITS  COOKED  WITHOUT  SUGAR. 

Baked  apples.  Prune  dessert.  Apple  jelly  without 

Baked  pears.  Steamed  prunes.  sugar. 

Baked  apple  dessert.  Stewed  prunes.  Cranberries  and 

Baked  tomato.  Stewed  raisins.  sweet  apples. 

Prune  marmalade.  Stewed  tomato.  Apples  stewed  with 

raisins. 

FRUITS  COOKED  WITH  GRAINS. 

Pearled  wheat  with  Rice  with  raisins.  Raisin  gruel. 

raisins.  Rice  with  peaches.  Macaroni  with 

Pearled  barley  with  Graham  grits  with  tomato  sauce. 

raisins.  raisins  or  figs.  Banana  toast. 

Cracked  wheat  with  Graham  apple  mush.  Tomato  toast. 

steamed  apple.  Granola  fruit  mush.  Prune  toast. 

Farina  with  fig  sauce.  Farina  with  fresh  fruit.    Prune  pie  with 

Rice  with  fig  sauce.  Poached  eggs.  granola  crust. 

B.   Foods  which  Encourage  Asepsis  of  the  Stomach  ami  Intestines. 

All  the  articles  named  in  the  preceding  list  of  ster- 
ilized foods  prepared  without  milk  or  eggs,  with  the 
addition  of  the  following  :  — 

Kumyss.  Floated  eggs.  Soft  boiled  eggs. 

Kumyzoon.  Poached  eggs.  Beaten  whole  eggs. 

Medium  boiled  eggs.  Curdled  eggs.  Cottage  cheese. 

Beaten  whites  of  eggs.  Hard  boiled  yolks  of  eggs. 

C.    Foods  which  do  not  Ferment  in  a  Stomach  of 
Moderate  Digestive  Vigor. 

All  the  preparations  of  grains,  fruits,  milk,  eggs, 
and  easily  digested  vegetables  in  Diet  Lists  Nos.  1  to 
10,  only  raw  milk  excepted. 

With  this  list  it  is  necessary  for  many  patients  who 
have  long  suffered  from  dilatation  of  the  stomach,  to 
employ  some  intestinal  antiseptic,  of  which  the  best  is 
charcoal,  in  the  form  of  antiseptic  charcoal  tablets  (49). 

DIET  LIST  SO.  2.— DRY  DIETARY. 

A  dry  dietary  is  indicated  in  cases  in  which  there  is 
dilatation  of  the  stomach,  with  slow  absorption.  In 


TREATMENT    OF    DYSPEPSIA.  229 

cases  of  this  sort,  liquid  foods  remain  too  long  in  the 
stomach. 

The  chief  purpose  of  a  dry  dietary  is  to  secure  thor- 
ough mastication  of  the  food  ;  hence  the  articles  in  the 
following  lists  should  be  taken  without  water,  milk,  or 
other  liquid.  Granose  is  an  ideal  article  of  food  for  a 
dry  diet,  as  it  stimulates  the  flow  of  saliva  to  a  greater 
extent  than  any  other  food  with  which  we  are  ac- 
quainted. Granose,  combined  with  nuts,  nut  meal, 
bromose,  or  the  yolks  of  hard  boiled  eggs,  may  often 
be  eaten  with  advantage  almost  exclusively  for  a  few 
days  at  the  beginning  of  a  course  of  dry  dietary. 

A.    Dry  Diet. 

This  list  includes  all  the  unfermented  breads  ( Diet 
List  No.  13),  and  in  addition, — 

Yolks  of  hard  boiled  eggs.  Bromose  ( dry ).  Nut  butter. 

Granose.  Popped  corn.  Nut  meal. 

Steamed  figs.  Sterilized  butter.  Roasted  almonds. 

Raisins. 

B.    Modified  Dry  Diet. 

This  list  includes  all  the  preceding  list  (  A ),  and  in 
addition  the  following  :  — 

Poached  eggs.  Beaten  whole  eggs.  Popped  corn. 

Curdled  eggs.  Nuts.  Mashed  peas. 

Floated  eggs.  Granose  grits.  Mashed  beans. 

Beaten  whites  of  eggs.  Browned  rice.  Stewed  prunes. 

DIET  LIST  NO.  3 — NITROGENOUS  DIETARY. 

The  nitrogenous  elements  of  food  are  also  pepto- 
gens  ;  that  is,  they  stimulate  the  secretion  of  gastric 
juice,  and  hence  foods  of  this  class  are  especially 
adapted  to  cases  of  hypopepsia  and  apepsia,  in  which 


230 


THE    STOMACH. 


the  production  of  gastric  juice  is  always  deficient.  Al- 
bumen and  casein  are  the  most  important  nitrogenous 
elements.  Eggs  consist  chiefly  of  albumen  ;  milk  con- 
tains casein  in  abundance  ;  nuts  are  rich  in  albumen 
and  vegetable  casein  ;  peas,  beans,  and  lentils  contain 
a  very  large  proportion  of  vegetable  casein.  At  the 
beginning  of  a  course  of  treatment,  in  extreme  cases  of 
apepsia  and  hypopepsia,  it  is  sometimes  necessary  to 
confine  the  diet  to  a  single  nitrogenous  food,  as  kumyss 
or  kumyzoon.  Later,  eggs  may  be  added  advanta- 
geously, then  some  farinaceous  food,  as  granose,  with 
nuts,  and  still  later  the  various  unfermented  breads  and 
soft  grain  preparations  ;  but  dry  foods  are  to  be  pre- 
ferred. 


Beans  pure"e. 

Peas  puree. 

Nuts  puree. 

Milk  (Diet  List  No.  5). 


Almond  meal. 
Lentils  with  nuts. 
Peas  with  nuts. 


Gluten  biscuit,  1,  2.  Beans. 

Gluten  meal.  Peas. 

Eggs  (Diet  List  No.  6).        Lentils. 


NUT  PREPARATIONS. 

Beans  with  nuts. 
Nuts  puree. 
Bromose. 

DIET  LIST  SO.  4. 


Nut  porridge. 
Nut  butter. 
Nut  meal. 


This  list  consists  exclusively  of  farinaceous  prepara- 
tions of  a  character  easy  of  digestion. 

BREADS. 

(Diet  List  No.  13.) 

TOASTS. 
Cream  toast.         Snowflake.         Gravy  toast.        Dry  toast  with  hot  milk. 

SOUPS. 
Cream  rice  soup.        Oatmeal  soup.        Cream  barley  soup.        Corn  soup. 


TREATMENT    OF    DYSPEPSIA. 


231 


Gluten  mush. 
Oatmeal  mush. 
Graham  mush. 
Granola  mush. 
Mixed  mush. 
Corn-meal. 
Barley  gruel. 
Graham  grits  gruel. 
Gluten  water  gruel. 
Oatmeal  gruel. 
Milk  gruel. 
Graham  gruel. 
Corn-meal  gruel. 
Oatmeal  porridge. 
Oatmeal  blanc-mauge. 


GRAINS. 

Macaroni  baked  with 

granola. 
Macaroni  with  cream 

sauce. 

Jellied  oatmeal. 
Barley  milk. 
Milk  panada 
Bran  jelly. 
Kice. 

Eice  molded. 
Browned  rice. 
Eice  water. 
Grain  jelly. 
Cracked  wheat. 
Molded  wheat. 
Boiled  wheat. 


Rolled  wheat. 
Wheat  goflo. 
Graham  grits. 
Gluten. 
Granola. 
Eolled  oats. 
Rolled  rye. 
Pearled  wheat. 
Hulled  corn. 
Popped  corn. 
Hominy. 
Hominy  flakes. 
Corn  gofio. 
Grains  of  gold. 
Crystal  wheat. 


DIET  LIST  NO.  5.— MILK. 


Hot  milk. 
Buttermilk. 


Boiled  milk. 
Sterilized  milk. 


Cream. 
Cottage  cheese. 


Kumyss. 
Kumyzoon. 


DIET  LIST  NO.  G. 

A 


This  list  is  composed    entirely   of    preparations    of 
eggs. 

Medium  boiled  eggs.  Soft  boiled  eggs.  Curdled  eggs. 

Hard  boiled  yolks  of  eggs.  Poached  eggs.  Beaten  whites  of 

Beaten  whole  eggs.  Floated  eggs.  eggs. 

B 

The  articles  in  this  list  contain  milk  or  some  cereal 
preparation  in  addition  to  eggs. 


Gluten  custard. 
Gluten  meal  custard. 
Bread  custard. 
Farina  custard. 


Granose  custard.  Cream  toast  with 
Rice  custard.  poached  eggs. 

Eice  with  egg.  Poached  eggs  on 
Cracked  wheat  custard.         toast. 


DIET  LIST  NO.  7. 

Foods    which   are  easily  disintegrated,  and    hence 
adapted  to  cases  of  dilatation  of  the  stomach. 


UNFERMENTED  BREADS. 

(Diet  List  No.  13.) 


232 


THE    STOMACH. 


Gluten  mush. 
Granola  mush. 
Granose. 


Strawberries. 


Baked  apples. 


GRAINS. 
Granola. 
Gluten. 
Rice. 

FRESH  FRUITS. 

Grapes.  Oranges. 

FRUITS  WITHOUT  SUGAR. 
Stewed  prunes.          Prune  dessert. 
FRUITS  COOKED  WITH  GRAINS. 


Browned  rice. 
Corn  gofio. 
Popped  corn. 


Ripe  sweet  apples. 


Fruit  juice. 


Graham  peach  mush. 
Grape  mush. 
Granola  grape  mush. 
Oatmeal  fruit  mush. 
Granola  fruit  mush. 
Granola  peach  mush. 
Graham  apple  mush. 
Blackberry  mush. 
Raspberry  granola 

mush. 

Granola  apple  mush. 
Lemon  barley  gruel. 
Raspberry  grits  gruel. 
Raisin  gruel. 
Grape  gruel. 
Lemon  gluten  gruel. 
Lemon  oatmeal  gruel. 
Boiled  wheat. 


Peas  pure'e. 
Lentil  puree. 
Split  peas. 


Macaroni  with  tomato 

sauce. 

Rice  with  fig  sauce. 
Farina  with  fig  sauce. 
Pearled  barley. 
Grape  toast. 
Prune  toast. 
Banana  toast. 
Tomato  toast. 
Apricot  toast. 
Berry  toast. 
Peach  toast. 
Farina  fruit  mold. 
Red  rice  mold. 
Pearled  wheat  with 

raisins. 
Pearled  barley  with 

raisins. 

VEGETABLES  AND  LEGUMES. 
Green  peas. 
Vegetable  broth. 
Corn  pulp. 


EGGS. 

Medium  boiled  eggs.  Poached  eggs. 

Beaten  whites  of  eggs.         Curdled  eggs. 
Hard  boiled  yolks  of  eggs.  Floated  eggs. 


New  Era  Kumyss. 
Kumyss  nog. 
Kumyzoon. 


MISCELLANEOUS. 
Sterilized  butter. 
Caramel-cereal . 


Graham  grits  with 
raisins,  dates,  or 
figs. 

Rice  with  raisins. 

Wheat  with  berries. 

Farina  with  fresh 
fruit. 

Rice  and  stewed 
apple  dessert. 

Cracked  wheat  with 
steamed  apple. 

Apple  macaroni. 

Stewed  fruit  puddi'g. 

Wheat  with  peaches. 

Rice  with  peaches. 

Prune  pie  with  gra- 
nola crust. 

Granose  shortcake. 


Kornlet. 
Asparagus. 
Nuts  with  lentils. 


Soft  boiled  eggs. 
Beaten  whole  eggs. 


Bromose. 
Nut  butter. 
Nut  meal. 


DIET  LIST  NO.  8.— ANTI-FAT  DIETARY. 

An  anti-fat  dietary  need  not  necessarily  exclude  all 
starchy  foods.  The  most  important  points  to  be  ob- 
served are  — 


TREATMENT    OF    DYSPEPSIA.  233 

1.  Limitation  of  food  to  the  smallest  amount  with 
which  the  strength  can  be  maintained. 

2.  Restriction  of  the  diet  to  one  article,  or  at  most 
to  two  or  three. 

3.  Avoidance  of  fats. 

4.  Avoidance  of  liquid  foods  of  all  sorts.     If  ku- 
myss  or  kumyzoon  is  used,  it  should  be  made  the  chief 
dietary. 

Kumyss.  Beaten  whole  eggs.  Grapes. 

Kumyzoon.  Vegetable  broth.  Lemons. 

Granose  (eaten  dry).  Gluten.  Celery  (cooked). 

Hard  rolls.  Gluten  biscuit.  Asparagus. 

Water  biscuit.  Gluten  wafers.  Tomatoes. 

Medium  boiled  eggs.  Gluten  custard.  String  beans. 

Beaten  whites  of  eggs.  Sour  apples.  Green  peas. 

Poached  eggs.  Oranges.  Greens. 

Curdled  eggs.  Strawberries.  Sticks. 

Floated  eggs.  Bananas.  Zwieback. 
Soft  boiled  eggs. 

DIET  LIST  NO.  9.— FAT  AND  BLOOD  DIETARY. 

Those  foods  which  abound  in  starch,  sugar,  dex- 
trin, and  easily  digested  fats,  are  the  most  conducive 
to  fattening.  At  the  head  of  the  list  stands  bromose, 
which  contains  one  fourth  its  weight  of  emulsified,  or 
partially  digested,  nut  fat,  and  nearly  forty  per  cent,  of 
digested  starch.  The  following  articles  are  fattening 
in  character  :  — 

Milk  (Diet  List  No.  5).  Fruits  and  Nuts  (Diet       Diet  List  No.  7. 

Grains  (Diet  List  No.  4).  List  No.  10).  Diet  List  No.  13. 

Diet  List  No.  6.  Bromose. 

DIET  LIST  NO.  10.— FRUITS  AND  NUTS. 

A.- FRESH  FRUITS. 

Grapes.  Oranges.  Peaches.  Pears.  Berries. 

Melons.  Pineapples.          Bananas.  Figs.  Dates. 

Raisins.  Apples.  Cherries.  Currants. 


THE    STOMACH. 


B.- FRUITS  COOKED  WITHOUT  SUGAR. 

Baked  apples.  Stewed  prunes.  Cranberries  and 

Stewed  raisins.  Apple  jelly  without  sweet  apples. 

Apples  stewed  withraisins.        sugar.  Baked  apple  dessert. 

Stewed  tomato.  Prune  dessert.  Baked  tomato. 

Baked  pears.  Prune  marmalade.  Stewed  prum-s. 

C.- FRUITS  WITH  SUGAR. 

Unfermented  wine.  Grape  jelly.  Lemon  apple. 

Stewed  fruits.  Fruit  juices.  Citron  apple. 

Canned  fruits.  Baked  quince.  Bananas  in  fruit 

sirup. 
D.-NUTS. 

Almonds.  Chestnuts  boiled  or  Nut  meal. 

Hickory  nuts.  roasted.  Nut  porridge. 

Filberts.  Almond  meal.  Nut  butter. 


DIET  LIST  NO.  11.— LIQUID  DIETARY. 

A  liquid  dietary  is  especially  indicated  in  fevers," 
and  in  some  cases  of  painful  dyspepsia,  especially  cases 
of  hyperpepsia  accompanied  by  much  irritation,  as  in- 
dicated by  pain  on  pressure  over  the  pit  of  the  stomach 
and  pain  after  eating.  The  purpose  of  a  liquid  diet  is 
to  present  nutriment  in  a  form  which  will  tax  the  stom- 
ach as  little  as  possible,  and  secure  the  early  emptying 
of  the  stomach  by  the  passage  of  its  liquid  contents 
into  the  small  intestine. 

Gluten  gruel.  Fruit  juices.  Kumyss. 

Malted  gluten  gruel.  Barley  water.  Kumyss  nog. 

Fruit  and  nuts  gruel.  Nut  porridge.  Kumyzoon. 

Nuts  and  gluten  gruel.        Cream.  Cottage  cheese. 

Vegetable  soup(pea,  lentil,  Hot  milk.  Curdled  eggs. 

bean,  tomato,  rice,  bar-  Boiled  milk.  Beat'n  whitesof  eggs. 

ley,  and  corn).  Buttermilk.  Beaten  whole  eggs. 

Vegetable  broth.  Custard.  Bromose. 

DIET  LIST  NO.  12.— FEVER  DIET. 

In  fever  the  digestive  powers  are  feeble.  With  the 
exception  of  boiled  rice,  only  liquid  food  should  be 


TREATMENT    OF    DYSPEPSIA.     •  235 

taken.     Gruels  and  similar  farinaceous  preparations  are 
most  suitable,  and  they  should  be  boiled  several  hours. 

A.  To  be  used  during  the  active  period  of  the  fever, 
while  the  temperature  is  high  :  — 

Barley  water.  Granola  gruel.  Prunes  puree. 

Barley  gruel.  Gluten  gruel.  Bromose. 

Strained  oatmeal  gruel.       Fruit  and  nut  gruel.  Kumyss. 

Boiled  rice.  Unfermented  grape  Kumyzoon. 

Corn-meal  gruel.  juice.  Buttermilk. 

Fruit  juices. 

B.  During  convalescence,  in  addition  to  the  above, 
the  following  may  be  used  :  — 

Milk  porridge.  Whipped  egg.  Peaches. 

Cream  toast.  Kumyss  nog.  Grapes. 

Granola  mush.  Stewed  fruit.  Zwieback. 

Granose.  Baked  apples.  Unfermentedbreads. 

Poached  eggs.  Strawberries.  Toasted  whole-wheat 

Custard.  wafers. 

DIET  LIST  NO.  13.— UNFERMENTED  BREADS. 

Whole-wheat  puffs.  Snow  gems.  Beaten  biscuit. 

Corn  puffs.  Whole-wheat  gems.  Fig  sandwich. 

Graham  puffs.  Gluten  wafers.  Apple  sandwich. 

Rolls.  Whole-wheat  wafers.  Graham  flakes. 

Toasted  rolls.  Toasted  wafers.  Gluten. 

Fruit  rolls.  Dyspeptic  wafers.  Granola. 

Breakfast  rolls.  Crisps.  Crusts. 

Graham  gems.  Graham  crisps.  Zwieback. 

Rye  gems.  Graham  crackers.  Sticks. 

Blueberry  gems.  Toasted  beaten  biscuit.  Hoe  cake. 

DIET  LIST  NO.  14.— FOR  A  BOTTLE-FED  INFANT 
UNDER  SIX  MONTHS  OF  AGE. 

Sterilized  cow's  milk  properly  diluted  with  boiled 
water,  barley  water,  or  oatmeal  water.  Under  three 
months  of  age,  use  one  third  milk  ;  three  to  six  months, 
one  half  milk  ;  after  six  months,  two  thirds  milk. 

Barley  Water. —  Boil  one  tablespoonful  of  whole  barley  in  an 
enameled  sauce-pan  or  a  double  boiler  for  five  minutes,  and  throw 
the  water  away  ;  then  add  one  and  one-half  pints  of  water,  slowly 
simmer  down  to  one  pint,  then  strain.  To  be  used  for  diluting 


236  THE    STOMACH. 

milk,  or  as  a  substitute  for  it  when  cow's  milk  does  not  agree,  and 
in  cases  of  vomiting. 

Oatmeal  Water. —  One  tablespoonful  of  fine  oatmeal,  one  pint 
of  boiling  water.  Boil  for  one  hour,  keeping  the  quantity  of  wa- 
ter good  ;  strain.  To  be  used  instead  of  plain  water  for  diluting 
milk. 

Barley  Water  and  Cream. —  Five  parts  of  barley  water  made 
as  directed  above,  to  one  part  of  sterilized  cream. 
Substitute  for  Mother's  Milk :  — 

Milk 1  oz. 

Cream 2  oz. 

Bicarbonate  of  soda 1  gr. 

Milk  sugar 3  dr. 

Water  to  make S  ox. 

Gradually  increase  the  quantity  of  cream  and  milk  as  the 
child  advances  in  age. 

DIET  LIST  NO.  15.— FOR  A  TEETHING  INFANT. 

As  soon  as  a  child  begins  to  cut  its  teeth,  it  should 
begin  to  use  them.  In  addition  to  Diet  List  No.  14, 
the  child  may  be  fed  stewed  fruits  in  small  quantities, 
those  being  avoided  which  require  much  sugar  for  sweet- 
ening. Such  fresh  fruits  as  strawberries,  grapes  (ex- 
cluding the  seeds  and  skins),  ripe  peaches,  and  very  ripe 
sweet  or  subacid  apples  may  be  given,  also  baked 
sweet  apples  and  pears.  Granose  eaten  dry,  or  granose 
and  granola  eaten  with  milk  or  fruit  juice,  are  perhaps 
the  best  of  all  cereal  foods  for  an  infant.  Zwieback 
softened  with  milk  or  cream,  and  gluten  gruel  (Sani- 
tarium Infant  Food)  are  also  excellent. 

DIET  LIST  NO.  16.—  FOR  A  CHILD  FROM  ONE  TO 
FIVE  YEARS  OF  AGE. 

The  most  suitable  foods  are  those  in  Diet  Lists 
Nos.  1  and  2,  which  a  child  from  two  to  five  years 
of  age  may  eat  without  injury,  provided,  of  course,  that 


TREATMENT    OF    DYSPEPSIA.  237 

the  food  is  properly  masticated.  Vegetables  should  be 
avoided  until  the  second  teeth  begin  to  make  their  ap- 
pearance, with  the  exception  of  the  following  :  Aspara- 
gus, green  peas,  and  baked  sweet  potatoes.  Children 
subject  to  colic  or  other  forms  of  indigestion  should 
avoid  potatoes.  Purees  of  lentils,  peas,  and  beans, 
and  bean  porridge  may  be  allowed. 

The  articles  included  in  Diet  Lists  Nos.  22  and  23 
should  never  enter  into  the  dietary  of  children,  being  still 
more  unwholesome  for  them  than  for  adults. 

DIET  LIST  NO.  17.— EATING  FOR  STRENGTH. 

Those  articles  are  most  useful  in  developing  nerv~ 
ous  and  muscular  energy  which  are  the  most  easily 
digestible,  while  at  the  same  time  possessed  of  the 
highest  nutritive  value.  The  nutritive  value  of  the 
following  articles  is,  on  an  average,  with  the  ex- 
ception of  eggs,  about  three  times  that  of  beefsteak, 
while  they  tax  the  digestive  organs  less  :  Peas,  beans, 
lentils,  whole-grain  preparations,  bromose,  granose, 
granola,  unfermented  bread.  The  food  preparations 
mentioned  in  Diet  List  No.  1  are  especially  to  be  com- 
mended for  producing  strength. 

DIET  LIST  NO.  18.—  DIET  FOR  DIABETES. 

An  exclusive  meat  diet  was  formerly  recommended 
for  diabetes,  but  it  is  now  known  that  such  a  dietary 
does  not  give  the  most  satisfactory  results,  and  in- 
volves the  danger  of  sudden  death  from  an  excessive 
accumulation  of  tissue  poisons  which  the  kidneys  are 
unable  to  eliminate. 

Gluten  biscuit.  Asparagus,  Kumyss.  Nuts. 

Lettuce.  Spinach,  Cottage  cheese.     Nut  butter. 

Celery.  Greens,  Buttermilk  Nut  meal. 


238 


THE    STOMACH. 


DIET  LIST  NO.  19.— FOR  RHEUMATISM  AND  GOUT. 

It  is  especially  important  to  avoid  an  excess  of  ni- 
trogenous food ;  hence  meats  of  all  kinds  must  be 
avoided.  In  cases  of  dilatation  of  the  stomach,  milk 
must  also  be  avoided.  In  most  cases  the  articles  in- 
cluded in  the  following  diet  lists  are  to  be  preferred  :  — 

Dry  foods  (Diet  List  No.  2).  Fruits  and  nuts  (Diet  List  No.  10). 

Aseptic  dietary  (Diet  List  No.  1)  and  Diet  List  No.  6. 

DIET  LIST  NO.  20. 

For  gastritis,  gastric  catarrh,  and  ulceration  of  the 
stomach. 


Liquid  foods  (Diet  List 

No.  11). 
Nut  puree. 


Nut  meal. 
Nut  porridge. 
Gluten  custard. 


Curdled  eggs. 

Egg-nog. 

Kumyzoon. 


DIET  LIST  NO.  21.— FOR  CONSTIPATION. 


Unfermented  graham 

breads. 

Cracked  wheat. 
Grits. 
Oatmeal  mush. 


Apples. 
Peaches. 
Most  raw  fruits. 
Stewed  fruits. 
Crystal  wheat. 


Bromose. 

Granose. 

Zwieback. 

Goflo. 

Pop-corn. 


DIET  LIST  NO.  22.— ARTICLES  DIFFICULT  OF  DIGESTION. 

ANIMAL  FOODS. 


Pork. 

Veal. 

Goose. 

Liver. 

Kidney. 

Heart. 

Sausage. 

Hard  boiled  eggs. 


Warm  bread,  espe- 
cially when  eaten 
with  butter. 

Muffins. 

Buttered  toast. 

Pies,  cakes,  and  all 
sorts  of  pastry. 


Scrambled  eggs. 

Cheese. 

Hashed    and    stewed 

meats. 
Salted    and    smoked 

meats. 
Melted  butter  and  all 

animal  fats. 

VEGETABLE  FOODS. 

Griddle-cakes. 

Fried  bread  and  vege- 
tables. 

Onions. 

Mushrooms. 

Pickles. 

Tea,  coffee,  cocoa, 
chocolate. 


Mackerel  and  all  oily  fish. 
Salt  fish. 

Dried  and  smoked  fish. 
Sardines  and  other  fish 

preserved  in  oil. 
Lobster,  crabs,  etc. 
Cooked  oysters  and  clams. 
Fried  meats  of  all   sorts. 


Mustard,  pepper,  spices, 

'and  other  condiments. 
Sugar,  preserves. 
Raw  grains  or  vegetables. 
Raw  or  imperfectly  cooked 
grains  and  vegetables. 
Ice-cream. 


TREATMENT    OF    DYSPEPSIA.  239 

FOODS  NOT  EASY  OF  DIGESTION. 

The  following  articles  are  much  more  digestible  than 
those  just  named,  but  are  nevertheless  so  difficult  of 
digestion  that  persons  with  dilated  stomachs  or  weak 
digestive  powers  are  compelled  to  wholly  abstain  from 
their  use  to  avoid  inconvenience  from  indigestion  :  — 

ANIMAL  FOODS. 

Animal  soups  of  all  sorts.  Tripe.  Codfish. 

Beef.  Turkey.  Oysters,  raw. 

Lamb.  Duck.  Butter. 

Game.  Pigeon.  Roast  meats. 

VEGETABLE  FOODS. 

Potatoes.  Plums.  Salads  of  all 

Turnips.  Cherries.  sorts. 

Cabbage.  Pineapples.  Currants. 

Tomatoes.  Beets.  Gooseberries. 

Peas  (whole  and  dried).  Carrots.  Raspberries. 

Beans  (whole  and  dried).  Spinach.  Blackberries. 

Raisins  and  most  dried  Parsnips.  Rhubarb, 

fruits.  Vegetable  soups.  Jellies. 

DIET  LIST  NO.  23.— FOODS  WHICH  PROMOTE  FERMENTA- 
TION AND  DECOMPOSITION  IN  THE  STOMACH. 

These  are  of  three  classes  :  A.  Foods  which  are  fer- 
menting or  decomposing  when  taken  into  the  stomach  •, 
B.  Foods  which  readily  undergo  fermentation  in  the 
conditions  present  in  the  stomach  when  the  digestive 
vigor  is  somewhat  impaired  ;  and  C.  Foods  which  fer- 
ment in  a  dilated  stomach. 

A.   Fermenting  or  Decomposing  Foods. 

Cheese.  Wine.  Wild  game  and  meat 

Sour  milk.  Cider.  which  has  a  gamey 

Sauerkraut.  Beer.  flavor. 

B.    Foods  which  Readily  Undergo  Fermentation. 

Sugar.  Sirups.  Meat. 

Honey.  Preserves  and  other.  Fish. 

Candy.  sweets.  Oysters. 

16 


240  THE    STOMACH. 

C.  Foods  which  Ferment  in  a  Dilated  Stomach. 

Mushes.  Sonps.  Other  soft  or  liquid  farina- 

Gruels.  Potatoes  and  other  vege-        ceous  foods, 

tables. 

DIET  LIST  NO.  24.— NUTRITIYE  EM3MATA. 

1.  Bromose  and  Egg. —  Dissolve  two  ounces  of  bromose  (Diet 
List  No.  25)  in  two  ounces  of  water.    Mix  with  a  beaten  egg  and  a 
half  teaspoonful  of  salt,  and  add  water  sufficient  to  make  eight 
or  ten  ounces.     Mix  well,  and  administer  with  a  suitable  syringe 
at  one  feeding.     Repeat  five  times  in  twenty-four  hours,  at  in- 
tervals of  four  hours.     This  is  the  best  material  for  rectal  ali- 
mentation with  which  we  are  acquainted.      Bromose  may  be 
obtained  from  the  Modern  Medicine  Co.,  Battle  Creek,  Mich. 

2.  Egg  Enema. — To  two  well-beaten  eggs  add  half  a  teaspoon- 
ful of  common  salt,  and  water  enough  to  make  twelve  ounces 
after  thorough  mixing.     This  quantity  is  sufficient  for  one  feed- 
ing.   Use  five  times  a  day,  at  intervals  of  four  hours.    This  prep- 
aration is  less  valuable  than  the  preceding,  but  may  be  used  in 
an  emergency. 

DIET  LIST  W.  25.— HEALTH  FOODS. 

The  following  foods  are  prepared  by  the  Battle 
Creek  Sanitarium  Health  Food  Company,  Battle  Creek, 
Mich. ,  IT.  S.  A.  They  are  of  great  service  in  the  treat- 
ment of  many  disorders  of  the  stomach  :  — 

Zwieback. —  Ordinary  fermented  bread  cut  into,  thin 
slices  and  baked  a  second  time  until  lightly  browned 
throughout. 

Graiwse. —  A  preparation  of  wheat  in  which  the 
grain  is  first  thoroughly  cooked,  then  compressed  into 
extremely  thin  flakes,  which  are  afterward  baked  until 
slightly  brown.  This  food  can  be  eaten  and  digested 
by  many  persons  who  can  digest  nothing  else. 

Granola. —  A  preparation  of  wheat,  corn,  and  oats, 
mingled  in  such  proportions  as  to  render  the  mixture  a 
perfect  food,  and  treated  in  such  a  manner  as  to  partly 


TREATMENT    OF    DYSPEPSIA.  241 

digest  it.  This  food  is  capable  of  sustaining  life  any 
length  of  time. 

Gluten  Biscuit.  —  A  small  biscuit  made  of  wheat 
flour  from  which  the  starch  has  been  carefully  sepa- 
rated by  washing.  From  this  biscuit,  carefully  dried 
and  browned,  gluten  meal  is  produced. 

Caramel- Cereal.— A.  substitute  for  coffee,  having  a 
pleasant,  aromatic  flavor,  and  free  from  the  unwhole- 
some properties  of  tea  and  coffee. 

Bromose. —  This  is  a  preparation  having  for  its  basis 
carefully  selected  and  prepared  nuts.  It  contains  about 
forty  per  cent,  of  digested  starch,  twenty-four  per  cent, 
of  digested  fats,  and  twenty  per  cent,  of  finely  divided 
albuminoids.  It  is  one  of  the  most  valuable  of  all  the 
fat-  and  blood-making  foods. 

Nut  Meal  and  Nut  Butter. —  These  are  nut  prod- 
ucts of  a  very  palatable,  wholesome,  and  highly  digest- 
ible character,  and  valuable  substitutes  for  animal  fats. 

Gofio. —  This  is  a  preparation  of  parched  grain  much 
employed  by  the  natives  of  the  Canary  Islands.  After 
being  parched,  the  grain  is  ground,  and  mixed  with 
milk  or  water. 

Kumyzoon. —  This  is  a  lactated  preparation  of  milk 
prepared  by  first  sterilizing  the  milk,  and  then  subject- 
ing it  to  the  action  of  a  special  lactic  acid  by  which  is 
produced  a  ferment  whereby  the  sugar  of  milk  contained 
in  it  is  converted  into  lactic  acid.  It  is  a  very  easily 
digestible  and  highly  nourishing  article  of  food,  and  is 
of  great  service  in  certain  forms  of  indigestion,  as  well 
as  in  diabetes  and  general  malnutrition.  Ordinary  ku- 
myss  and  buttermilk,  though  somewhat  inferior,  are 
useful  substitutes. 


242  THE    STOMACH. 

When  kumyzoon  is  made  the  sole  article  of  diet,  it 
should  be  taken  in  quantities  of  two  to '  three  quarts 
daily  and  at  intervals  of  four  or  five  hours  during 
the  day. 

Flesh  Food. —  It  will  be  noticed  that  meats  of  all 
kinds  are  omitted  from  these  lists.  The  reason  for  this 
is  that  flesh  foods  require  strong  digestive  powers  to 
disinfect  and  digest  them,  since  they  are  not  naturally 
adapted  to  the  human  stomach  ;  hence,  while  they  are 
apparently  well  tolerated  by  persons  in  health,  a  person 
whose  stomach  is  in  a  diseased  condition  will  do  better 
to  adhere  as  closely  as  possible  to  the  natural  diet  orig- 
inally intended  by  the  Creator  for  the  sustenance  of  hu- 
man beings,  as  indicated  by  the  command  to  Adam  :  "  I 
have  given  you  every  herb  bearing  seed,  which  is  upon 
the  face  of  all  the  earth,  and  every  tree,  in  the  which 
is  the  fruit  of  a  tree  yielding  seed  ;  to  you  it  shall  be 
for  meat."  According  to  the  most  eminent  compara- 
tive anatomists,  the  anatomical  structure  and  digestive 
functions  of  man  agree  entirely  with  those  of  such 
purely  frugivorous  animals  as  the  chimpanzee,  the 
orang-outang,  and  the  gorilla. 

Antisepsis  of  the  Mouth. —  So  long  as  the 
mouth  is  swarming  with  microbes,  which  is  always  the 
case  when  the  tongue  is  coated,  and  the  teeth  uncleanly 
and  presenting  unfilled  cavities,  thousands  of  germs  are 
carried  down  into  the  stomach  with  every  mouthful  of 
food  or  drink  swallowed.  The  first  step  toward  asep- 
sis of  the  stomach,  and  a  most  essential  thing  in  the 
treatment  of  indigestion,  is  mouth  cleanliness. 

Modern  researches  have  shown  that  nearly  all  dis- 
eases of  the  mouth,  as  well  as  a  large  share  of  the  dis- 


TREATMENT  OF  DYSPEPSIA.  243 

eases  of  the  stomach,  are  due  to  the  action  of  germs 
which  find  lodgment  there.  The  mouth  is  peculiarly 
exposed  to  the  attacks  of  germs,  as  it  is  located  at  the 
very  entrance  of  the  body,  and  a  portion,  at  least,  of  the 
respired  air  passes  through  it,  and  the  germs  readily 
find  lodgment  about  the  tongue,  cheeks,  between  the 
teeth,  and  elsewhere.  The  mucus  secreted  by  the 
glands  of  the  mucous  membrane  lining  the  mouth,  is,  to 
some  degree,  antiseptic  in  character,  and  possesses 
germicidal,  or  germ-destroying,  properties  to  some  ex- 
tent. When  the  mouth  is  kept  clean,  this  disinfecting 
mucus  is  capable  of  thoroughly  protecting  the  struc- 
tures of  this  portion  of  the  body  against  the  attacks  of 
microbes  ;  but  when  particles  of  food  are  left  to  lodge 
between  the  teeth,  the  germs,  finding  abundant  soil  in 
which  to  grow  and  multiply,  become  so  numerous  that 
the  poisonous  substances  which  they  produce  neutral- 
ize the  antiseptic  mucus  so  that  it  becomes  powerless 
for  protection. 

Meat,  more  than  all  other  foods,  is  injurious  in  this 
respect,  for  the  reason  that  its  fibers  readily  lodge  be- 
tween the  teeth,  and  are  not  easily  removed,  and  for 
the  further  reason  that  it  furnishes  a  kind  of  soil  in 
which  germs  grow  with  the  greatest  rapidity  and  de- 
velop the  most  virulent  properties. 

It  is  thus  apparent  that  thorough  cleanliness  of  the 
teeth  and  mouth  is  one  of  the  most  important  hygienic 
measures.  This  fact  becomes  still  more  apparent  when 
we  remember  that  the  act  of  eating  or  drinking  and  the 
frequently  repeated  act  of  swallowing  to  clear  the  throat 
from  mucus,  a  practice  which  cannot  be  too  much  dep- 
recated, are  the  means  of  carrying  down  into  the  stom- 


244  THE    STOMACH. 

ach  any  microbes  which  may  be  present  in  the  mouth. 
There  are  certain  microbes,  also,  which  seem  to  have 
their  habitat  in  the  mouth,  particularly  those  of  diph- 
theria, pneumonia,  and  consumption.  It  is  not  known 
that  these  germs  propagate  outside  the  human  body, 
except  under  artificial  conditions  ;  but  they  find  ready 
lodgment  in  the  mouth,  and  are  often  present  there  in 
persons  apparently  enjoying  perfect  health,  waiting  the 
opportunity  when  a  severe  cold  or  some  other  depress- 
ing agent  shall,  by  reducing  the  resistance  of  the  body, 
enable  them  to  obtain  a  stronger  foothold,  and  to  mani- 
fest their  presence  by  the  characteristic  symptoms  of 
diphtheria,  pneumonia,  or  some  form  of  tubercular 
disease. 

A  very  excellent  means  of  cleansing  the  teeth  is  the 
Antiseptic  Dentifrice  prepared  by  the  Modern  Medicine 
Company,  Battle  Creek,  Mich.  The  basis  of  this  prep- 
aration is  the  extract  of  the  bark  of  the  famous  soap- 
tree  of  South  America,  one  of  the  most  remarkable 
cleansing  agents  known.  The  antiseptic  properties  of 
the  dentifrice  are  due  to  the  pure  cinnamon  oil  which  is 
added.  These  substances  are  combined  with  very  fine 
precipitated  chalk,  making  a  detergent  paste  which  is 
most  effective  in  its  cleansing  action.  Directions  for 
the  use  of  the  dentifrice  accompany  each  package. 
Simply  rinsing  the  mouth  with  cinnamon  water,  pre- 
pared by  adding  half  a  teaspoonful  of  cinnamon  essence 
to  half  a  glassful  of  water,  is  a  useful  means  of  disin- 
fecting the  mouth,  to  be  used  after  thorough  cleansing 
with  a  tooth-brush. 

Artificial  teeth  must  receive  as  scrupulous  care  as 
the  natural  teeth.  It  is  considered  best  that  they  should 


TREATMENT    OF    DYSPEPSIA.  245 

be  removed  at  night.  After  thorough  cleansing  they 
should  be  placed  in  a  proper  receptacle  containing  a 
quantity  of  pure  water.  This  will  prevent  deposit  from 
insects  and  the  development  of  fungi,  which  often  grow 
with  great  rapidity,  especially  in  warm  seasons  of  the 
year. 

The  distinguishing  features  of  the  several  forms  of 
dyspepsia  and  the  general  line  of  regimen  and  treat- 
ment necessary  to  effect  a  cure,  are  pointed  out  with 
greater  definiteness  than  heretofore  in  this  work  in  the 
following  classification,  which  is  based  upon  symptoms 
rather  than  upon  the  examination  of  the  stomach  fluid, 
which  is  the  more  scientific  method,  and  the  one  habitu- 
ally employed  in  the  treatment  of  patients  at  the  Battle 
Creek  Sanitarium  (see  page  134).  The  suggestions 
made,  if  thoroughly  understood  and  efficiently  applied, 
cannot  fail  to  be  of  great  service,  although  based  only 
upon  symptoms.  Those  who  can  do  so  should  by  all 
means  avail  themselves  of  the  advantages  of  treatment 
at  a  sanitarium  where  treatment  is  based  on  the  exami- 
nation of  the  stomach  fluid. 

Simple  Dyspepsia. —  This,  the  simplest  and 
most  common  form  of  the  malady,  is  sometimes  called 
slow  digestion.  It  is  common  in  both  men  and  women, 
and  especially  affects  sedentary  people  and  those  nerv- 
ous persons  who  eat  rapidly  and  swallow  their  food 
without  proper  mastication.  It  is  also  common  in 
persons  whose  teeth  'are  defective.  Its  immediate 
cause  is  deficient  activity  of  the  muscular  walls  of  the 
stomach  and  intestines.  The  symptoms  are  much  the 
same  as  those  which  follow  the  taking  of  an  excess  of 
food,  but  are  felt  even  when  only  a  moderate  amount 


THE    STOMACH. 

has  been  taken.  An  hour  or  two  after  eating,  a  sensa- 
tion of  weight  and  oppression  is  felt.  The  discomfort 
continues  for  some  hours,  gradually  wearing  off  before 
the  next  meal.  The  appetite  is  usually  fairly  good, 
but  often  is  not  ready  for  the  reception  of  food  at  meal- 
time, as  the  work  of  digesting  the  previous  meal  has 
not  yet  been  completed.  Sometimes  there  is  consider- 
able flatulence  of  the  stomach,  the  eructations  being 
tasteless,  and  never  offensive ;  pain  between  the 
shoulders  or  beneath  one  shoulder-blade,  and  not  in- 
frequently in  the  region  of  the  heart.  Palpitation  of 
the  heart  often  occurs  in  the  night,  causing  great  alarm 
on  the  part  of  the  patient  and  his  friends,  who  entertain 
fears  of  sudden  death.  Sleep  is  disturbed  and  unre- 
freshing.  The  tongue  is  frequently  foul  in  the  morn- 
ing, with  a  bad  taste  in  the  month.  All  the  symptoms 
mentioned  are  greatly  exaggerated  by  a  late  supper,  or 
by  any  unusual  excess  in  quantity  or  quality  of  food. 
The  bowels  are  apt  to  be  constipated.  When  the  diffi- 
culty has  been  of  long  standing,  there  is  usually  ob- 
served a  marked  disposition  to  sleep  after  meals,  or 
unnatural  sleepiness  at  other  times,  and  a  decided  loss 
of  vivacity  and  energy. 

Examination  of  the  stomach  fluid  in  these  cases 
shows  a  normal  amount  of  work  done,  but  the  work 
is  poor  in  quality.  There  is  usually  more  or  less  de- 
composition of  the  food  elements  and  the  formation 
of  abnormal  products  which,  when  absorbed  into  the 
blood,  give  rise  to  the  general  symptoms  already  re- 
ferred to. 

Treatment.  —  The  indications  in  slow  digestion  are 
for  improvement  of  the  vigor  of  the  body  in  general, 


TREATMENT    OF    DYSPEPSIA.  247 

especially  of  the  organs  concerned  in  the  digestive 
process,  and  suppression,  so  far  as  possible,  of  the 
action  of  germs  in  the  stomach  and  bowels.  The 
following  measures  faithfully  followed  will  be  found 
serviceable  :  — 

1.  Eat  simple,  dry  food,  taking  pains  to  masticate 
it    very  thoroughly.       Granose,    zwieback,    rolls,    and 
other  unfermented    breads    constitute   the  staple   arti- 
cles of  diet.     To  these  may  be  added   cooked  fruits. 
The    only  raw   fruits   which   may    be    eaten,   in    most 
cases,    are  perfectly  fresh  and   well-ripened    peaches, 
grapes,  and  strawberries.     Very  ripe  sweet  apples  are 
well  tolerated  by  most  patients,  if  eaten  with  dry  food 
and  carefully  masticated.     Nuts,   well  masticated,  are 
not   objectionable.     Milk  is  tolerated  in  some   cases, 
but  is  better  avoided  by  most  patients,  unless   taken 
in    the   form   of    kumyss,    kumyzoon,    buttermilk,    or 
cottage  cheese.     Sweets  of  all  kinds  must  be  carefully 
avoided,  also  drinking  at  meals,  iced  foods,  rich  pies, 
pastry,  rich  gravies,  pickles,  condiments,  and  all  foods 
difficult  of  digestion. 

2.  The  cool  morning  sponge  bath  (1),  a  warm  bath 
once  or  twice  a  week  (2,   16,   17),  followed  by  a  cool 
shower  (4)    or   sponge  bath,    general    applications   of 
electricity  (66,  68),  when  possible,  dry  rubbing  with  a 
flesh-brush  or  towel  at  night  before  retiring,  a  salt  glow 
(3)  two  or  three  times  a  week,  are  the  most  serviceable 
measures  which  can  be  employed  at  home.     A  hot  bag 
may  be  applied  over  the  stomach  for  half  an  hour  after 
each  meal,  to  hasten  the  digestive  process.     Gentle  ex- 
ercise or  kneading   of  the    stomach  (31)  after  eating 
also  hastens  the  digestive  process.     The  moist  abdom- 


248  THE    STOMACH. 

inal  bandage  (9)  at  night  encourages  intestinal  activity, 
promotes  secretion,  and  relieves  congestion  of  the  vis- 
cera. A  dry  flannel  bandage  worn  about  the  abdomen 
during  the  daytime  is  also  helpful,  especially  in  cold 
weather.  Regularity  of  the  bowels  must  be  secured, 
by  the  enema,  if  necessary,  and  by  other  measures  recom- 
mended for  the  relief  of  constipation.  Electricity 
applied  to  the  spine  and  over  the  stomach  is  also  a 
stimulant  to  the  digestive  processes,  and  useful  to  re- 
lieve constipation.  The  hot  and  cold  full  bath  (21) 
is  an  excellent  means  of  arousing  activity  of  the  secret- 
ing organs  connected  with  digestion. 

Swedish  movements  (39,  42),  both  manual  and 
mechanical,  are  very  helpful. 

Some  ten  years  ago  the  writer  devised  a  vibrating 
chair  which  has  been  found  very  helpful  in  this  class 
of  cases,  also  a  kneading  apparatus  by  which  the  stom- 
ach and  bowels  may  be  kneaded  in  a  most  efficient  man- 
ner. This,  together  with  numerous  other  machines  for 
applying  movements  to  the  body  which  have  been  de: 
vised  by  the  author,  are  used  in  the  Swedish  movement 
department  of  the  Battle  Creek  Sanitarium.  The  can- 
non-ball (Fig.  2,  Plate  VIII)  is  also  helpful  in  stimu- 
lating the  activity  of  the  intestines,  particularly  as  a 
means  of  relieving  constipation. 

3.  Abundance  of  outdoor  exercise  is  indispensable 
in  the  treatment  of  this  as  well  as  all  other  forms  of 
indigestion.  It  not  only  creates  a  demand  for  food, 
but  increases  the  ability  to  digest  it.  Horseback  rid- 
ing, bicycle  riding,  and  boating  are  all  excellent  means 
of  exercise,  but  are  perhaps  not  preferable  to  useful 
labor  in  the  cultivation  of  the  soil. 


TREATMENT  OF  DYSPEPSIA.  249 

A  course  of  "  General  Tonic  Treatment "  (page  333) 
is  required.  In  very  feeble  patients  a  course  of  nutri- 
tive treatment  (page  331)  should  be  given  at  first  as  a 
preparation  for  the  more  vigorous  tonic  measures. 

In  this,  as  well  as  in  all  other  forms  of  indigestion 
in  which  germs  play  an  active  part,  some  intestinal  an- 
tiseptic, one  of  the  best  of  which  is  antiseptic  char- 
coal tablets  (4-9),  is  found  to  be  almost  indispensable. 
Two  or  three  tablets  should  be  taken  after  each  meal, 
and  continued  for  several  months. 

Acid  Dyspepsia. —  This  form  of  indigestion  is 
that  in  which  the  digestion  is  so  slow  that  the  food 
undergoes  fermentation,  forming  acids  which  irritate 
the  stomach,  and  give  rise  to  the  same  symptoms,  much 
exaggerated,  which  are  mentioned  as  pertaining  to 
simple  dyspepsia,  with  several  additional  ones,  the 
principal  of  which  are  heartburn,  regurgitation  of  in- 
tensely sour  liquid  from  the  stomach,  and  acid  eruc- 
tations ;  a  white  tongue,  frequently  with  transverse 
fissures,  often  flabby  and  indented  at  the  edges  ;  acid 
saliva,  causing  decay  of  the  teeth  ;  irregular  bowels, 
either  constipated  or  unnaturally  loose  ;  grinding  of  the 
teeth  at  night ;  and  a  reddish  sediment  in  the  urine. 
There  is  quite  likely  also  to  be  pain  at  the  pit  of  the 
stomach,  with  soreness  on  pressure.  The  digestion  be- 
ing very  slow,  portions  of  fermenting  food  remain  in 
the  stomach  from  one  meal  to  another,  so  that  acidity 
becomes  habitual.  No  one  case  presents  all  of  these 
symptoms,  but  several  are  often  present. 

Patients  suffering  with  this  form  of  dyspepsia  are 
usually  very  thin  and  bloodless.  Occasionally,  how- 
ever, a  case  of  the  opposite  kind  is  met,  in  which 


250  THE    STOMACH. 

there  is  an  abundance  of  tissue,  though  of  a  loose, 
flabby  texture.  Women  suffer  from  acidity  more  fre- 
quently than  do  men.  • 

Sweet  foods,  such  as  pastry,  sweetcakes,  preserves, 
etc.,  and  in  severe  cases  even  starchy  foods,  especially 
vegetables,  and  sometimes  also  fruits,  aggravate  the 
tendency  to  acidity. 

Treatment. — In  these  cases,  patients  are  frequently 
found  subsisting  almost  wholly  on  a  meat  diet,  for  the 
reason  that  they  find  flesh  food  less  likely  to  form 
acids  than  are  cereals  and  vegetable  foods.  This  prac- 
tice, however,  aggravates  the  disease  in  the  end,  and 
never  effects  a  cure.  The  measures  suggested  for  the 
relief  of  simple  dyspepsia  are  equally  appropriate  for 
this  condition.  In  addition,  it  is  necessary  in  some 
cases  —  in  all  cases,  in  fact,  in  which  the  tendency  to 
acidity  is  very  pronounced — to  cleanse  the  stomach  at 
least  two  or  three  times  a  week,  and  sometimes  daily, 
by  means  of  the  stomach-tube  (4-6).  The  best  time  for 
washing  the  stomach  is  at  night.  The  extreme  slow- 
ness of  the  digestive  work  renders  more  than  two  meals 
a  day  impossible  without  injury.  The  interval  be- 
tween the  two  meals  should  be  at  least  seven  hours, 
unless  the  quantity  of  food  taken  is  very  small,  in 
which  case  it  may  be  as  short  as  four  or  five  hours, 
and  the  number  of  meals  may  be  increased.  The 
longer  interval,  however,  is  preferable.  Milk,  un- 
fermented  bread,  sugar,  uncooked  fruits,  very  acid 
fruits,  fruits  and  vegetables  together,  and  coarse  vege- 
tables should  be  especially  avoided,  also  all  articles  dif- 
ficult of  digestion,  and  likely  to  cause  fermentation  (Diet 
Lists  Nos.  22,  23).  Wheat  charcoal  in  its  ordinary 


TREATMENT    OF    DYSPEPSIA.  251 

form,  or  better  in  the  form  of  antiseptic  charcoal  tablets 
(4-9),  is  almost  indispensable  in  the  treatment  of  this 
condition. 

A  course  of  ' '  General  Tonic  Treatment ' '  (page  333), 
preceded  in  feeble  cases  with  nutritive  treatment  (page 
331),  is  indicated  in  these  cases. 

Bilious  or  Foul  Dyspepsia,  or  Septic  Indi- 
gestion.—  The  term  bilious  is  used  to  distinguish 
this  form  of  indigestion,  not  because  either  the  liver  or 
the  bile  is  the  immediate  cause,  but  because  of  the  bil- 
ious vomiting  and  sallow  appearance  of  the  skin  which 
usually  accompanies  this  condition.  This  is  what  is 
generally  known  as  ' '  biliousness. ' '  Acute  dyspepsia 
of  the  same  nature  is  termed  ' '  a  bilious  attack. ' ' 
Women,  tailors,  shoemakers,  and  sedentary  persons 
generally,  are  particularly  subject  to  this  form  of  the 
disease. 

As  in  acid  dyspepsia,  this  form  of  indigestion  differs 
from  simple  dyspepsia  chiefly  in  the  exaggeration  of 
the  morbid  conditions  present  in  that  form  of  the  dis- 
ease. Digestion  being  still  slower  than  in  acid  dys- 
pepsia, the  characteristic  symptoms  occur  more  remotely 
from  the  time  of  eating.  The  usual  time  for  the  ap- 
pearance of  the  most  marked  symptoms  is  in  the  morn- 
ing before  breakfast.  Headache,  great  flatulence,  a 
very  foul  tongue,  a  bitter  taste  in  the  mouth,  with 
nausea  and  finally  vomiting  of  undigested  and  partially 
decayed  food,  indicate  the  inactivity  of  the  digestive 
organs.  When  vomiting  is  continued,  bile  is  generally 
expelled,  the  duodenum  being  affected,  and  taking  part 
in  the  expulsive  action.  Diarrhea  often  accompanies 
and  in  some  cases  takes  the  place  of  the  vomiting. 


L'L 


252  THE    STOMACH. 

Owing  to  this  thorough  clearing  out  of  the  stomach 
and  bowels,  these  attacks  usually  occur  at  intervals  of 
at  least  several  days.  They  are  often  periodical,  how- 
ever, recurring  sometimes  as  often  as  once  or  twice  a 
week,  and  again  not  oftener  than  once  in  two  to  four 
weeks. 

In  addition  to  the  more  important  symptoms  men- 
tioned may  be  noted  headache,  often  of  a  "splitting" 
or  throbbing  character,  fetid  eructations,  and.  usually 
severe  pain  in  the  eyes. 

Farinaceous  foods  give  much  less  trouble  than  meats, 
especially  fat  meats.  Vegetables  eaten  with  fat,  pas- 
try, milk,  meat  which  has  been  kept  too  long,  and 
sometimes  eggs,  especially  those  not  perfectly  fresh, 
with  albuminous  and  fatty  foods  generally,  increase  tlie 
symptoms  peculiar  to  bilious  dyspepsia,  and  bring  on 
the  attacks.  In  some  cases  the  disease  seems  to  be  due 
to  inability  to  digest  starchy  foods.  This  is  especially 
true  as  regards  the  starch  of  vegetables.  Sufferers  from 
this  difficulty  often  make  themselves  worse  by  the  use 
of  purgative  medicines. 

Treatment. —  Employ  the  same  measures  recom- 
mended for  simple  dyspepsia  and  acid  dyspepsia,  taking 
care  to  give  even  greater  attention  to  intestinal  asepsis. 
Use  an  aseptic  diet  (Diet  List  No.  1).  It  may  be  nec- 
essary to  resort  to  an  exclusive  kumyzoon  or  buttermilk 
diet  (Diet  List  No.  25)  for  a  short  time.  A  diet  con- 
sisting of  granose  (Diet  List  No.  25),  with  fruit,  with 
or  without  the  addition  of  nut  meal,  is  an  admirable 
dietary  to  be  followed  for  a  week  or  two  in  bilious  dys- 
pepsia. Granola,  and  most  other  cercil  foods,  if  prop- 
erly cooked,  agree  well  with  this  class  of  cases.  As 

- 


TREATMENT    OF    DYSPEPSIA.  253 

severe  constipation  usually  exists,  special  attention  must 
be  given  to  the  relief  of  this  condition  (see  page  279). 

Lavage  (4-6)  one  to  three  times  weekly  is  necessary 
in  the  majority  of  cases  of  bilious  dyspepsia.  Charcoal 
or  antiseptic  charcoal  tablets  (47,  48,  49)  should  be 
taken  after  each  meal.  A  diet  of  granose  or  zwieback, 
bromose  (Diet  List  No.  25),  and  stewed  fruit,  will,  in 
most  cases,  effect  a  radical  change  within  a  few  days 
in  cases  of  this  kind. 

Painful  Dyspepsia. —  The  chief  characteristic 
of  this  disease  is  tenderness  at  the  pit  of  the  stomach, 
usually  just  at  the  lower  end  of  the  sternum,  but  some- 
times affecting  other  portions  of  the  stomach  and  also 
the  duodenum,  the  pain  in  the  latter  region  being  often 
mistaken  for  some  affection  of  the  liver.  In  occasional 
cases  the  sensibility  extends  to  other  parts  of  the  small 
intestine. 

The  tenderness  described  is  almost  always  accom 
panied  by  a  very  unpleasant  sensation  at  the  epigas- 
trium or  extending  along  under  the  sternum,  described 
by  the  patient  as  a  "  tearing, "  "  burning, "  "  rasping, " 
"gnawing"  pain,  which  comes  on  soon  after  taking 
food.  This  pain  may  be  due  to  a  morbid  sensibility  of 
the  mucous  membrane,  or  to  a  congested  state  usually 
called  chronic  inflammation  of  the  stomach,  or  chronic 
gastritis,  accompanied  by  a  catarrhal  secretion  resem- 
bling that  from  any  other  mucous  membrane  in  a  like 
condition.  When  the  pain  is  due  to  morbid  sensibility 
of  the  stomach,  it  usually  ceases  when  digestion  is  com- 
pleted. When  due  to  congestion,  it  is  continuous,  and 
is  sometimes  relieved  to  a  degree  by  taking  a  moderate 
amount  of  bland  food  when  the  stomach  becomes, 


L'.VI  THE    STOMACH. 

empty.  The  pain  is  often  accompanied  by  throbbing 
of  the  aorta,  felt  at  the  pit  of  the  stomach  or  below. 
Sexual  excesses  are  a  very  common  cause  of  irritability 
of  the  stomach  in  both  sexes. 

Not  infrequently  the  congestion  to  which  this  pain 
is  sometimes  due  is  caused  by  compression  of  the  ab- 
dominal organs,  obstructing  free  circulation.  Hence 
women  who  wear  corsets  are  very  liable  to  be  affected 
by  it,  though  they  will  rarely  admit  the  cause,  and 
still  more  rarely  can  be  induced  to  remove  it.  As  a 
pithy  writer  once  said,  women  have  a  strong  "won't," 
which  they  sometimes  oppose  to  all  arguments,  no  mat- 
ter how  irresistible  may  be  the  logic. 

Tiwitnicnt. —  In  this  condition  it  is  often  advan- 
tageous to  place  the  patient  upon  a  diet  of  kumyzoon 
for  u  few  weeks,  adding  eggs  and  some  simple  farina- 
ceous preparations,  such  as  granola  or  gluten  mush  (Diet 
List  No.  25).  The  general  measures  employed  may  be 
the  same  as  those  for  simple  and  acid  dyspepsia.  A 
hot  trunk  pack  (7)  usually  gives  relief  from  pain  in  the 
region  of  the  stomach,  abdomen,  and  spine. 

Frequent  eating,  which  is  so  often  resorted  to  as  a 
means  of  relieving  the  discomfort  experienced  in  this 
form  of  dyspepsia,  is  a  most  pernicious  practise,  and 
serves  only  to  aggravate  the  disease  in  the  end.  If 
eating  is  followed  by  pain,  it  may  be  necessary  to  con- 
fine the  diet  to  the  very  blandest  articles  of  food,  such 
as  gluten  mush  or  gruel,  granola  mush,  buttermilk,  and 
pure'es  of  fruit,  peas,  or  other  legumes.  Diet  List  No. 
7  is  especially  suitable. 

In  some  cases  it  is  preferable  for  a  time  to  give  the 
patient  a  small  quantity  of  food  three  or  four  times  a 


TREATMENT    OF    DYSPEPSIA.  255 

day,  than  a  larger  amount  twice  a  day,  as  the  stomach 
is  thus  not  so  severely  taxed  as  by  two  hearty  meals. 
When  food  is  administered  more  than  twice  daily, 
care  should  be  taken  to  give  only  the  most  easily  di- 
gestible food.  The  two  principal  meals  should  be  taken 
as  far  apart  as  possible,  and  the  intermediate  meals 
should  consist  only  of  liquid  foods.  We  have  found 
the  hours  of  8  A.  M.  and  3  p.  M.  the  most  suitable  for 
the  principal  meals,  and  12  M.  and  7  P.  M.  for  the 
minor  meals.  Not  infrequently  the  appetite  is  unnat- 
ural, the  exercise  of  much  will-power  being  required  to 
control  it.  In  many  cases  the  pain  occasioned  by  tak- 
ing food  may  be  relieved  by  the  administration  of  twenty 
to  thirty  grains  of  subnitrate  of  bismuth  before  each 
meal.  The  remedy  is  a  harmless  one,  but  colors  the 
stools  black,  from  the  action  of  the  sulphide  of  hydro- 
gen of  the  feces  upon  the  bismuth. 

Such  articles  as  cracked  and  crushed  wheat,  oatmeal, 
graham  bread,  and  other  foods  containing  the  coarser 
parts  of  the  grain,  are  likely  to  do  harm  in  this  form  of 
dyspepsia,  the  woody  outside  parts  of  the  grain  acting  as 
a  mechanical  irritant  to  the  sensitive  mucous  membrane 
of  the  stomach.  It  is  this  fact  which  has  given  seeming 
occasion  for  an  ignorant  class  of  writers  to  declaim  so 
loudly  against  the  use  of  whole-wheat  flour.  The  fact 
that  the  coarser  parts  of  the  grain  can  with  advantage 
be  removed  for  certain  cases,  is  no  evidence  against  its 
wholesomeness  or  its  utility  in  most  other  cases  of  in- 
digestion. Granose  is  a  most  suitable  food. 

In  severe  cases,  it   is   often  necessary  to  put  the 
patient  on  an  extremely  simple  diet.     As  a  usual  thing, 
nothing  answers  the  indications  so  well  as  milk.     It 
17 


256  THE    STOMACH. 

should  be  taken  as  fresh  as  possible,  and  about  as 
warm  as  can  be  borne  with  comfort,  unless  there  is 
considerable  fever,  when  it  may  be  taken  in  small 
quantities  iced.  In  extreme  cases,  the  irritability  may 
be  so  great  that  the  food  will  be  rejected  if  received  in 
any  but  small  quantities.  If  necessary,  so  small  an 
amount  as  one  or  two  spoonfuls  may  be  given  once  an 
hour  at  first,  both  the  quantity  and  the  intervals  being 
gradually  increased  until  the  necessary  amount  is  taken 
at  the  usual  intervals  of  meals.  Then  a  little  well- 
boiled  and  strained  oatmeal  or  graham  gruel  may  be 
added,  the  quantity  being  increased  until  the  patient 
can  bear  semi-solid  food.  Many  lives  have  been  saved 
by  tins-plan  when  death  seemed  imminent  because  of  the 
inability  to  digest  sufficient  nourishment.  Sometimes 
even  milk  is  found  intolerable  ;  in  such  cases  the  most 
successful  results  are  often  obtained  by  the  use  of  the 
white  of  egg  beaten  to  a  froth,  and  made  palatable  by 
the  addition  of  a  few  drops  of  lemon  or  other. fruit  juice. 

In  this  form  of  dyspepsia,  the  patient  is  apt  to  feel 
a  terrible  faintness  as  soon  as  the  stomach  becomes 
empty.  This  is  in  some  degree  relieved  by  taking 
food,  which  often  leads  the  patient  to  resort  to  frequent 
eating  when  there  is  no  requirement  for  so  doing,  and 
the  result  is  only  detrimental.  The  methods  of  reliev- 
ing many  painful  symptoms  which  occur  in  connection 
with  this  disease  have  already  been  described  in  this 
work  (see  page  155), 

In  feeble  patients,  nutritive  treatment,  and  in  more 
vigorous  cases  nutritive  treatment  followed  by  tonic 
treatment  (pages  331  and  333),  should  be  employed, 

application  of  galvanism  (69)  to  the  spine  and  abdo- 


TREATMENT    OF    DYSPEPSIA.  257 

men  is  an  excellent  means  of  relieving  the  irritation  of 
the  abdominal  sympathetic  nerve,  to  which  most  of 
the  symptoms  are  directly  or  indirectly  traceable.  The 
treatment  indicated  for  hyperpepsia  is  necessary  in 
many  cases  of  painful  dyspepsia. 

Gastric  Neurasthenia,  or  Nervous  Dys- 
pepsia. —  The  sympathy  between  the  stomach  and  the 
brain  is  very  marked.  Disease  of.  the  stomach  may  be 
produced  by  mental  disorders,  and  on  the  other  hand, 
various  mental  and  nervous  affections  may  arise  from 
disease  of  the  «etomach.  Indeed,  cases  sometimes  occur 
in  which  the  most  prominent  symptoms  of  dyspepsia, 
by  which  alone  the  disease  may  be  recognized,  mani- 
fest themselves  through  the  nervous  system.  All  the 
symptoms  previously  enumerated  under  the  head  of 
mental  and  nervous  disturbances  are  observed  in  these 
cases. 

The  stomach  symptoms  of  indigestion  are  sometimes 
so  slight  as  not  to  be  easily  distinguished  ;  yet  there  is 
undoubtedly  a  serious  fault  in  the  elaboration -of  the 
food.  The  process  of  digestion  is  left  incomplete,  and 
the  blood  becomes  full  of  crude,  unassimilated  material, 
which  not  only  does  not  impart  to  the  tissues  new  life 
and  vigor,  but  is  a  direct  source  'of  irritation  and  poi- 
soning. The  brain,  being  the  most  sensitive  part  of  the 
nervous  system,  of  course  suffers  most  ;  and  hence  there 
is  abundant  cause  for  the  mental  depression,  unbalanced 
mental  action,  confusion  of  ideas,  vacillation  of  judg- 
ment, perversity  of  disposition,  and  other  kindred  dis- 
turbances from  which  the  nervous  dyspeptic  suffers. 

Many  persons,  finding  themselves  in  this  wretched 
state,  and  not  realizing  the  influence  of  physical  condi- 


258  THE    STOMACH. 

tions  upon  the  mind,  fall  into  hopeless  despair,  even 
when  no  intentionally  wrong  act  has  been  committed. 
At  first  there  is  observed  simply  an  exaggeration  of 
real  difficulties  or  misfortunes  ;  but  after  a  time  the  in- 
dividual settles  into  a  state  of  gloom,  despondency,  and 
mental  depression,  in  which  he  suffers  with  troubles  that 
are  purely  imaginary. 

Nervous  dyspeptics  often  suffer  much  in  mind  from 
a  morbid  sensitiveness.  They  imagine  themselves  the 
subjects  of  criticism  or  ridicule,  and  therefore  become 
morose,  irritable,  and  exceedingly  unhappy.  Occasion- 
ally they  find  themselves  haunted  with  evil  thoughts, 
and  sometimes  with  almost  irresistible  impulses  to  com- 
mit improper  or  criminal  acts,  as  blasphemy,  suicide, 
etc.  They  are  almost  certain  to  imagine  themselves 
suffering  from  many  different  diseases,  usually  of  an 
incurable  nature. 

It  is  observed  that  mental  disorders  of  the  character 
described  are  often  the  result  of  intestinal  dyspepsia,  a 
form  of  the  disease  in  which  the  local  symptoms  are 
less  prominent  than  those  which  relate  to  the  stomach, 
but  equally  grave. 

This  class  of  patients  are  often  greatly  injured  by 
the  use  of  mineral  waters,  which,  not  being  absorbed 
readily,  remain  long  in  the  stomach,  and  serve  to  in- 
crease the  nervous  irritability. 

In  nervous  dyspepsia  the  symptoms  characteristic  of 
the  disease  are  due  to  an  overexcited  or  irritated  state 
of  the  sympathetic  nerves.  This  is  usually  the  result  of 
dilatation  or  prolapse  of  the  stomach,  and  is  the  direct 
consequence  either  of  the  strain  upon  the  abdominal 
sympathetic  nerves  from  the  weight  of  the  prolapsed 


TREATMENT    OF    DYSPEPSIA.  259 

stomach,  or  colon,  or  other  abdominal  organs,  or  of  the 
absorption  of  the  irritating  products  of  the  fermenta- 
tion and  decomposition  taking  place  in  the  stomach, 
through  its  inability  to  unload  its  contents  into  the  in- 
testine with  sufficient  promptness. 

Treatment. —  In  the  treatment  of  gastric  neuras- 
thenia, or  nervous  dyspepsia,  the  services  of  a  skilled 
physician  are  usually  required.  Many  patients  suf- 
fering from  this  disorder  need  a  change  of  scene  and 
surroundings,  and  relief  from  the  home  cares  and 
business  worries  which  have  been  largely  responsible 
for  the  production  of  the  disease.  Hence  they  can 
be  more  successfully  treated  in  a  sanitarium  than 
at  home ;  and  even  in  a  well-equipped  institution, 
the  ingenuity  and  skill  of  the  physician  are  often 
taxed  to  the  utmost  to  bring  about  a  successful  re- 
covery. Not  the  least  difficult  task  to  be  accom- 
plished is  the  deliverance  of  the  patient  from  the 
morbid  fancies  which  haunt  him  and  make  him  in 
imagination  a  prey  to  almost  every  ill  to  which  human 
flesh  is  heir. 

The  general  measures  of  treatment  are  the  same 
as  those  recommended  for  simple  dyspepsia  and  acid 
digestion.  A  few  special  measures,  however,  will 
be  found  of  service,  particularly  the  hot  and  cold 
trunk  pack  (8),  and  the  application  of  electricity  to  such 
remote  parts  as  the  arms,  legs,  back,  etc.  (65,  67). 
Headache,  a  symptom  of  nervous  dyspepsia,  is  often 
relieved  by  the  application  of  heat  to  the  back  of  the 
head,  a  cold  compress  over  the  forehead,  including 
also  the  eyes  in  cases  in  which  the  distress  extends 
to  these  organs.  In  some  cases  an  ice-bag  to  the 


260  THE    STOMACH. 

back  of  the  head,  and  a  fomentation  (10)  to  the  top  of 
the  head  or  over  the  eyes,  gives  more  immediate 
relief.  Hot  and  cold  sponging  of  the  spine  (18)  is  a 
valuable  means  for  exciting  the  vasomotor  centers 
of  the  spine.  Galvanism  of  the  spine  and  abdomen 
(69)  promotes  secretion,  and  relieves  congestion  of  the 
viscera.  As  prolapse  of  the  abdominal  viscera  ex- 
ists in  many  cases  of  this  class,  the  Natural  Abdom- 
inal Supporter  plays  an  important  part  in  treatment  (45). 
The  same  must  be  said  of  abdominal  massage  (29) 
and  manual  Swedish  movements  (4-0). 

Hypopepsia  and  Apepsia. —  It  is  not  easy 
to  determine  the  presence  or  absence  of  hypopep- 
sia  or  apepsia  without  a  careful  examination  of  the 
stomach  fluid  ;  but  when  this  condition  is  known 
to  exist, — and  it  may  be  suspected  in  all  cases  of 
great  debility,  especially  in  those  in  which  there  is 
dilatation  of  the  stomach  and  prolapse  of  the  viscera 
in  persons  past  middle  age, —  vigorous  stimulating 
measures  for  the  development  of  both  muscular  and 
secretory  activity  in  the  stomach  must  be  employed. 
In  these  cases  special  attention  must  be  given  to  the 
application  of  heat  over  the  stomach,  abdominal  mas- 
sage (29),  hot  and  cold  trunk  pack  (8),  and  manual 
Swedish  movements  (39,  4-1).  Moderate  exercise 
directly  after  eating  encourages  the  secretion  of  gastric 
juice.  Two  other  measures  of  treatment  which  have 
not  been  mentioned  should  be  employed  in  these  cases, 
especially  when  there  is  any  considerable  degree  of 
tenderness  over  the  region  of  the  stomach  :  — 

1.  The  hot  and  cold  douche  over  the  stomach  (20). 

2.  The  hot  and  cold  douche  applied  to  the  stomach 


TREATMENT  OF  DYSPEPSIA.  261 

itself  through  the  stomach-tube,  or  hot  and  cold  la- 
vage (4-6).  This  may  be  employed  whenever  the  stom- 
ach is  washed  out,  if  frequent  lavage  is  necessary, 
or  the  stomach-tube  may  be  introduced  two  or  three 
times  a  week  for  the  purpose  of  applying  this  vig- 
orous stimulating  measure,  even  if  lavage  is  not 
necessary  for  the  removal  of  fermenting  food  or 
mucus. 

The  dietetic  measures  recommended  for  simple  dys- 
pepsia should  be  employed  in  hypopepsia  without 
acidity,  and  those  for  acid  dyspepsia  in  hypopepsia 
accompanied  by  fermentation  of  the  food. 

What  about  Pepsin  ?  —  The  use  of  pepsin  in 
cases  of  so-called  atonic  dyspepsia,  or  hypopepsia,  is 
very  general,  and  many  tons  of  this  digestive  ferment 
borrowed  from  the  stomach  of  the  hog  are  annually 
swallowed  by  human  beings.  It  is  doubtful,  however, 
whether  any  benefit  whatever  is  derived  from  the  use  of 
this  substance.  Some  years  ago  Mosso,  by  experiments 
upon  a  dog,  determined  that  the  stomach  of  a  dog  of 
ordinary  size  was  able  to  furnish  pepsin  enough  to  di- 
gest 70  kilograms,  or  154  pounds,  of  albumin.  This 
fact  was  ascertained  by  passing  through  the  dog' s  stom- 
ach 2000  litres  of  water,  acidulated  with  hydrochloric 
acid,  to  determine  the  degree  of  digestive  activity. 

More  recently,  Georges,  according  to  Debove  and 
Remond,  has  demonstrated  that  the  use  of  pepsin, 
papain,  and  pancreatin,  either  with  or  without  hydro- 
chloric acid,  are  valueless  to  supply  a  deficiency  of  pep- 
sin formed  by  the  glands  in  the  stomach.  My  own 
observations  exactly  agree,  in  this  respect,  with  those  of 
the  authorities  mentioned. 


262  THE    STOMACH. 

After  having  employed  pepsin  for  many  years,  on 
the  strength  of  authority,  I  long  ago  abandoned  its 
use,  together  with  that  of  other  digestive  ferments, 
with  the  exception  of  malt,  having  been  utterly  unable 
to  see  any  good  results  from  their  use.  What  the  stom- 
ach requires  in  cases  of  inactivity  of  the  gastric  glands, 
is  not  a  substitute  for  the  normal  product  of  these 
glands,  but  an  increase  of  the  activity  of  the  glands. 
Peptogens  are  needed  rather  than  peptones,  peptonoids, 
or  pepsins.  Proteid  substances  are  the  best  of  all  pep- 
togens.  The  natural  flavors  of  foods  and  the  dextrin 
developed  by  the  action  of  the  saliva  upon  starch  are 
also  peptogens  of  the  highest  value.  The  fact  last 
mentioned  furnishes  another  reason  for  the  use  of  dry 
food,  thus .  securing  thorough  mastication. 

One  of  the  very  best  peptogens  is  gluten.  Eggs 
and  milk  are  also  peptogenic  substances  of  value,  par- 
ticularly eggs.  The  peptogenic  power  of  gluten  was 
well  shown  in  a  case  examined  in  the  Sanitarium  Lab- 
oratory of  Hygiene,  in  which,  by  adding  gluten  to  the 
test  meal,  the  amount  of  free  HC1  was  increased  from 
.036  milligrams  to  .130  milligrams,  and  the  total  acidity 
from  .260  to  .35-4. 

The  popular  idea  that  pepper,  mustard,  and  similar 
substances  increase  digestive  vigor  has  been  found  by 
experiment  to  be  erroneous.  These  substances,  like 
common  salt-  in  excess,  increase  the  flow  of  mucus 
without  increasing  the  production  of  pepsin  or  hydro- 
chloric acid.  The  production  of  pepsin  and  hydrochloric 
acid  can  be  increased  only  by  natural  stimuli,  especially 
by  peptogenic  food  substances.  These  consist  (1)  of 
proteid  substances,  which  are  intended  to  be  digested 


TREATMENT    OF    DYSPEPSIA.  263 

by  the  action  of  pepsin  and  hydrochloric  acid  ;  (2)  of 
dextrin  and  maltose,  the  substances  which  naturally 
precede  peptone  in  the  order  of  production  in  the  di- 
gestive process  ;  and  (3)  of  food-flavors,  which  by  the 
reflex  action  produced  increase  the  activity  of  all  the 
digestive  glands  as  a  preparation  for  the  digestive  act  to 
follow. 

The  only  medicinal  agents  which  I  have  found  of 
any  value  whatever  in  the  treatment  of  hypopepsia  and 
apepsia,  have  been  antiseptics,  such  as  cereal  charcoal 
or  charcoal  in  the  form  of  antiseptic  charcoal  tablets 
(49)  previously  described,  lactic  acid  in  twenty-drop 
doses,  and  hydrochloric  acid  in  doses  of  five  to  eight 
drops  (51),  well  diluted,  half  an  hour  after  eating.  The 
use  of  antiseptics  is  a  matter  of  great  importance  in 
these  cases,  in  many  of  which  the  continued  use  of  an 
antiseptic  is  necessary,  owing  to  the  failure  of  the  stom- 
ach to  secrete  a  proper  amount  of  hydrochloric  acid. 
The  antiseptic  charcoal  tablets  are  a  remedy  which  can 
be  used  for  a  long  time  without  detriment.  Hydro- 
chloric acid  may  sometimes  be  used  for  a  few  weeks 
with  advantage,  but  should  not  be  depended  upon  for 
a  great  length  of  time.  The  stomach  must  be  trained 
to  make  its  own  hydrochloric  acid  in  proper  quantity  ; 
otherwise  no  permanent  improvement  will  be  secured. 
In  hypopepsia  and  apepsia  great  care  should  be  taken 
to  avoid  chilling  the  stomach  by  very  cold  foods. 

General  tonic  measures  are  required  (page  333).  In 
very  feeble  patients,  the  rest-cure  (page  329),  may  be 
first  needed  for  a  time,  and  it  is  sometimes  wise  to  em- 
ploy nutritive  treatment  (page  331)  for  a  few  weeks  be- 
fore beginning  more  vigorous  tonic  measures. 


264  THE    STOMACH. 

Hyperpepsia. —  The  symptoms  presented  in  this 
condition  are  in  many  cases  almost  identical  with  those 
of  ordinary  acid  dyspepsia.  The  condition  itself,  how- 
ever, is  very  different,  the  acidity  of  the  stomach  fluid 
being  due  to  an  excessive  secretion  of  hydrochloric  acid 
rather  than  to  fermentation.  Yet  in  some  cases  there 
is  both  an  excessive  formation  of  hydrochloric  acid  and 
fermentation.  This  combination  produces  the  most  ag- 
gravated of  all  forms  of  acid  dyspepsia.  The  acidity  of 
hyperpepsia  differs  from  that  of  acid  dyspepsia  in  the 
fact  that  it  usually  makes  its  appearance  soon  after  eat- 
ing, often  within  an  hour,  and  increases  as  long  as  the 
food  remains  in  the  stomach.  Not  infrequently  the  pa- 
tient suffers  from  headache  and  other  reflex  symptoms 
during  the  entire  period  occupied  by  the  digestive  proc- 
ess, almost  instant  relief  being  experienced  as  soon  as  the 
stomach  becomes  empty.  An  examination  of  the  stom- 
ach fluid  by  the  method  explained  elsewhere  in  this 
work  (page  134)  is  necessary  to  distinguish  with  cer- 
tainty between  hyperpepsia  and  ordinary  acid  dyspepsia. 

Treatment. — The  treatment  of  hyperpepsia  is  rad- 
ically different  from  that  required  for  the  relief  of  acid 
dyspepsia.  It  is  necessary  that  the  activity  of  the  stom- 
ach glands  should  be  diminished.  This  is  best  accom- 
plished by  the  following  means  :  Rest  for  one  or  two 
hours  after  eating  ;  an  aseptic  or  dry  dietary  (Diet  Lists 
Nos.  1  and  2)  ;  careful  avoidance  of  the  use  of  meats, 
condiments,  and  of  all  articles  difficult  of  digestion 
(Diet  List  No.  22).  When  fermentation  is  present, 
which  is  frequently  the  case,  especially  when  hyperpep- 
sia is  accompanied  by  dilatation  of  the  stomach,  articles 
likely  to  ferment  (Diet  List  No.  23)  and  preparations 


TREATMENT  OF  DYSPEPSIA.  265 

of  milk,  with  the  exception  of  kumyss,  kumyzoon,  and 
buttermilk,  must  be  carefully  avoided.  A  hot  or  cold 
pack  (8)  before  meals,  a  wet  girdle  (9)  at  night,  gen- 
eral tonic  treatment  or,  in  case  of  feeble  persons,  tonic 
treatment  preceded  by  nutritive  treatment  (pages  333 
and  331)  are  the  measures  indicated.  The  patient  should 
take  abundance  of  outdoor  exercise  daily.  Swedish 
movements  (39,  40)  may  be  employed  with  advantage, 
but  movements  should  not  be  taken  within  two  or  three 
hours  after  eating. 

In  very  severe  cases  it  is  sometimes  necessary  to  ad- 
minister soda  in  ten-  to  twenty-grain  doses  soon  after 
eating,  to  neutralize,  in  part,  the  excessively  acid  gas- 
tric juice. 

Catarrh  of  the  Stomach. —  This  condition  is 
characterized  by  the  production  of  an  excessive  quantity 
of  mucus  in  the  stomach.  The  tongue  is  heavily 
coated  ;  there  is  loss  of  appetite,  either  partial  or  com- 
plete ;  usually  tenderness  at  the  pit  of  the  stomach ;  con- 
stipation; in  many  cases  dilatation  or  prolapse  of  the 
stomach  ;  and  not  infrequently  occasional  attacks  of 
jaundice,  accompanied  by  severe  pain  similar  to  that  of 
gall-stone,  but  unlike  it,  in  that  it  does  not  terminate 
suddenly,  as  in  the  passage  of  gall-stones.  Jaundice 
in  these  cases  is  always  much  more  persistent  than  that 
which  appears  in  connection  with  gall-stones. 

Treatment. — In  the  treatment  of  catarrh  /)f  the 
stomach,  the  measures  recommended  for  simple  dys- 
pepsia and  painful  dyspepsia  should  be  employed. 
An  aseptic  diet  (Diet  List  No.  1)  agrees  best  with  these 
cases.  All  articles  difficult  of  digestion  (Diet  List  No. 
22)  and  liable  to  ferment  in  the  stomach  (Diet  List  No. 


266  THE    STOMACH. 

23)  should  be  carefully  avoided.  Granose,  granola,  and 
various  cereal  preparations,  with  fruits  and  nuts,  are 
most  suitable.  Lavage  (46)  should  be  practised  daily 
or  every  other  day,  if  the  tongue  is  very  foul,  and. 
marked  symptoms  of  indigestion  are  present.  "Gen- 
eral Tonic  Treatment"  (page 333)  should  be  given  in 
connection  with  the  other  measures  suggested.  In 
many  cases  a  considerable  quantity  of  water  will  be  re- 
quired to  wash  out  the  mucus  which  has  accumulated. 

The  moist  abdominal  bandage  (9)  and  the  hot  and 
cold  trunk  pack  (8)  should  be  assiduously  used,  and  for 
a  long  time.  Astringents  are  of  no  value.  If  con- 
siderable irritation  exists,  and  pain  after  eating,  twenty 
or  thirty  grains  of  subnitrate  of  bismuth  (62)  may  be 
taken  before  each  meal. 

Starch  Indigestion. —  Indigestion  of  starch  may 
be  the  result  of  several  causes  :  — 

1.  Insufficient  cooking  of  the  food. 

2.  Insufficient  mastication,  and  consequent  insuffi- 
cient insalivation. 

3.  An  excessively  acid  gastric  juice. 

4.  Improper  food    combinations,    as  the  eating  of 
vinegar   or   some   strong   vegetable   acid,    like   lemon 
juice,  in  connection  with  farinaceous  foods. 

5.  The  taking  of  a  large  quantity  of  fluid  with  the 
food,  thus  diluting  the  digestive  juices  to  an  excessive 
degree.    The  starch  of  vegetables  is  much  more  difficult 
of  digestion  than  that  of  most  grains.     Potatoes  seem 
to  be  more  liable  than  other  vegetables  to  give  rise  to 
indigestion  in  these  cases,  perhaps  from  the  fact  that 
they  contain  a-  larger  quantity  of  potash  than  other  vege- 


TREATMENT    OF    DYSPEPSIA.  267 

tables.  The  potash  salts  are  very  irritating  to  a  sensi- 
tive stomach. 

The  symptoms  of  starch  indigestion  are  flatulence, 
distention  of  the  stomach,  in  some  instances  acidity, 
with  eructations  of  gas  and  sour  liquids  —  in  other 
words,  the  symptoms  of  acid  dyspepsia. 

Treatment. —  The  treatment  consists  of  the  follow- 
ing measures  :  — 

1.  The  removal  of  each  of  the  causes  mentioned, 
which  have  been  sufficiently  clearly  indicated  to  render 
further  directions   unnecessary. 

2.  The  use  of  dry  and  thoroughly  sterilized  food. 
Germs  are  the  active  cause  of  the  indigestion  of  starch. 
Experiments  made   in  the  Laboratory  of  Hygiene  of 
the  Battle  Creek  Sanitarium  have   shown  that  a  test 
meal  consisting  of  granose  furnishes  no  germs  what- 
ever, all  the  microbes  swallowed  with  the  food  being 
destroyed  by  the  normal  gastric  juice  produced  when 
a  dry  and  well-sterilized  food  such  as  granose  is  eaten 
with  thorough  mastication. 

3.  The  use  of  some  good  antiseptic,  as  antiseptic 
charcoal  tablets. 

4.  The   employment  of  food  substances  free  from 
starch,   as   gluten,   malted  gluten,   and  in    some   cases 
malted  milk,   nuts,  nut  meal,   eggs,   kumyss  or  kumy- 
zoon,  buttermilk,   and  cottage  cheese.     A  nitrogenous 
dietary  (Diet  List  No.  3)  or  a  diet  of  fruits  and  nuts 
(Diet  List  No.    10)  may  be  advantageously  employed. 
Marked  benefit  is  frequently  experienced  from  the  use 
of  a  strictly  dry  diet  (Diet  List  No.  2). 

It  is  particularly  important  to  avoid  the  use  of  pota- 


268  THE    STOMACH. 

toes  and  starchy  vegetables.  Many  persons  can  digest 
well- boiled  rice  when  no  other  form  of  starchy  food  is 
tolerated.  Rice  starch  seems  to  be  more  easily  digested 
than  other  forms  of  starch.  It  is  necessary,  however, 
that  the  rice  should  be  cooked  in  such  a  manner  that 
the  grain  will  remain  whole  and  as  dry  as  possible. 

In  most  cases  great  benefit  may  be  derived  from  the 
use  of  bromose. 

Intestinal  Indigestion. —  The  most  prominent 
symptoms  of  intestinal  indigestion  are  distention  of  the 
bowels  with  gas,  colic  pains,  tenderness  about  the  um- 
bilicus, fetid  fecal  discharges,  loose,  watery  stools,  and 
in  some  instances  jaundice,  arising  from  extension  of 
intestinal  catarrh  into  the  bile  ducts.  Intestinal  in- 
digestion invariably  occurs  secondarily  to  gastric  indi- 
gestion. Hasty  mastication,  whereby  food  enters  the 
stomach  imperfectly  chewed,  and  after  a  time  worries 
itself  down  into  the  intestine,  there  to  become  a  source 
of  irritation,  is  one  of  the  most  common  causes  of  in- 
testinal indigestion.  The  use  of  condiments,  large 
quantities  of  sweets,  meat,  coarse  vegetables,  can- 
dies, ices,  etc.,  are  also  common  causes  of  intestinal 
dyspepsia. 

Treatment. —  Well-cooked  cereals,  cooked  fruits  of 
all  sorts,  kumyss,  kumyzoon,  or  buttermilk,  eggs,  and 
nut  meal  should  constitute  the  dietary  in  cases  of  intes- 
tinal dyspepsia.  Drinking  at  meals  should  be  care- 
fully avoided.  Antiseptic  charcoal  tablets  (4-9)  or  their 
equivalent  are  of  great  service  in  aiding  the  -stomach 
in  destroying  germs,  to  the  action  of  which  the  disturb- 
ance in  the  intestines  is  chiefly  due.  It  has  been 
recently  shown  by  careful  bacteriological  study,  that 


TREATMENT    OF    DYSPEPSIA.  26.9 

the  intestines  always  contain  fewer  germs  than  the 
stomach ;  •  so  that  if  the  contents  of  the  stomach  are 
made  perfectly  sterile,  it  is  reasonable  to  believe  that 
the  number  of  germs  in  the  small  intestine  may  thus  be 
rapidly  diminished. 

Fomentations  to  the  abdomen  at  night  (10),  followed 
by  the  moist  abdominal  bandage  worn  over  night  (9), 
also  a  cool  sponge  bath  (1)  every  morning,  preceded,  if 
necessary  to  avoid  chilliness,  by  fomentations  to  the 
spine  and  vigorous  rubbing  with  a  coarse  towel  or  a 
dry  flesh-brush,  are  the  most  important  measures  of 
treatment  which  can  well  be  employed  at  home.  If 
there  is  prolapse  of  the  bowels,  the  Natural  Abdominal 
Supporter  (45)  should  be  worn.  The  bowels  must  be 
kept  well  evacuated,  by  means  of  the  enema  (22)  or 
coloclyster  (23)  administered  daily,  if  necessary.  It 
should  be  employed  quite  hot  in  cases  of  looseness  of 
the  bowels  and  diarrhea,  and  at  a  lower  temperature 
in  cases  of  constipation.  If  much  mucus  is  present 
after  the  bowels  have  been  thoroughly  washed  out  by 
the  coloclyster,  a  quart  of  water  containing  one  dram 
of  tannin  may  be  taken  and  retained  for  ten  or  fifteen 
minutes,  the  remainder  then  being  passed  off.  See 
also  measures  recommended  elsewhere  for  diarrhea. 

Torpid  Liver. —  Errors  in  diet  may  justly  be 
said  to  be  the  most  frequent  of  all  the  causes  of  torpid- 
ity of  the  liver.  Fashionable  dinners,  late  suppers, 
overeating,  and  especially  the  excessive  use  of  fats, 
sugar,  pastry,  condiments,  alcoholic  drinks,  tea  and  cof- 
fee, are  the  most  common  causes  of  inactivity  of  this 
organ.  The  free  use  of  mustard,  ginger,  pepper,  curry 
powder,  and  other  irritating  condiments,  leads  to  the 


270  THE  STOMACH. 

almost  universal  prevalence  of  this  disease  in  many 
tropical  countries.  In  addition,  sedentary  habits,  the 
use  of  tobacco  and  other  narcotics,  restriction  of  the 
liver  by  wearing  tight  clothing,  and  also  malarial  dis- 
eases, may  be  mentioned  as  frequent  causes  of  torpidity 
of  the  liver.  The  prolonged  use  of  laxative  medicines, 
"after-dinner  pills,"  and  the  various  drugs  recom- 
mended for  constipation  are  most  prolific  sources  of 
torpid  liver.  The  same  may  be  said  of  mercury,  al- 
though this  drug  is  less  frequently  used  than  formerly. 
The  liver  possesses  the  curious  property  of  being 
able  to  retain  in  its  structure  metallic  poisons  which 
may  be  brought  to  it  in  the  circulation,  so  that  the 
injury  received  from  a  mercurial  course  is  apt  to  be 
more  or  less  permanent. 

Treatment.  —  In  severe  chronic  cases  of  this  affection 
the  patient  must  carefully  avoid  the  use  of  fats,  sugar, 
condiments,  and  alcoholic  drinks.  Regulation  of  the 
diet  is  a  positive  necessity  in  the  radical  treatment  of 
this  disease.  Tobacco,  if  used,  must  also  be  discon- 
tinued. If  the  patient' s  habits  are  sedentary,  he  must  be- 
gin a  course  of  regular,  systematic  exercise,  and  should 
strive  in  every  way  possible  to  build  up  his  general  health. 
Food  should  be  taken  in  moderate  quantities,  and 
should  consist  chiefly  of  grains,  nuts,  and  fruits.  Some 
are  obliged  to  avoid  the  use  of  milk,  while  with  others 
it  does  not  seem  to  disagree.  In  addition  to  these 
general  measures,  the  patient,  if  not  emaciated,  may 
with  advantage  take  two  or  three  vapor  baths  (16)  or 
packs  (6)  a  week  for  two  or  three  weeks.  The  wet 
girdle  (9)  should  be  worn  night  and  day.  The  use  of  the 
hot  and  cold  douche  over  the  liver  (20)  is  very  efficient, 


TREATMENT    OF    DYSPEPSIA.  27l 

Central  galvanization  may  also  be  applied  with  advan- 
tage. The  use  of  the  various  liver  medicines  which  are 
recommended  for  this  very  common  affection  will  do 
more  harm  than  good.  The  best  that  any  of  these 
drugs  can  do  is  to  whip  up  the  flagging  energies  of  the 
already  overworked  organ,  without  in  any  way  lightening 
its  burdens,  or  giving  it  increased  strength  to  perform 
the  labor  required  of  it.  The  repeated  use  of  reme- 
dies of  this  kind  greatly  aggravates  the  trouble,  as  it 
only  increases  the  inactivity  of  the  organ.  Mercury 
does  not  stimulate  the  liver,  as  is  commonly  sup- 
posed, but,  on  the  contrary,  lessens  its  activity. 

An  aseptic  dietary  ( Diet  List  No.  1 )  should  be 
adopted.  Kumyzoon  or  buttermilk  should  be  used  in 
place  of  milk,  and  in  many  cases  nut  meal  ( Diet  List 
No.  25 )  should  be  substituted  for  milk  and  butter. 
Fomentations  may  be  applied  over  the  liver  daily 
with  advantage,  and  a  cold  sponge  bath  taken  every 
morning. 

Vigorous  outdoor  exercise  is  a  matter  of  very  great 
importance.  Breathing  exercises  (38)  are  especially 
helpful,  as  they  aid  the  circulation  of  the  blood 
through  the  organ,  thus  diminishing  congestion.  So- 
called  torpidity  of  the  liver  is  chiefly  due  to  the  forma- 
tion of  poisonous  substances  in  the  stomach.  The 
liver  must  be  relieved,  as  far  as  possible,  of  all  un- 
necessary burdens  by  the  discarding  of  all  substances 
which  are  readily  decomposable  (Diet  List  No.  23). 
Intestinal  antiseptics  are  of  great  value.  Charcoal  or 
charcoal  tablets  (  47,  48,  49  )  may  be  constantly  used 
with  advantage  by  persons  who  habitually  suffer  from 
biliousness  or  torpidity  of  the  liver. 
18 


272  THE    STOMACH. 

Infantile  Dyspepsia. — The  most  common  symp- 
tom of  infantile  dyspepsia  is  vomiting.  When  the  mat- 
ters vomited  are  very  sour,  the  child  is  suffering  with 
acidity  of  the  stomach,  which  may  be  the  result  of  over- 
eating or  of  the  use  of  sugar  or  starchy  food.  Green, 
offensive  bowel  discharges  indicate  decomposition  of 
the  contents  of  the  intestines  in  consequence  of  imper- 
fect digestion.  The  green  discharges  are  generally  pre- 
ceded by  discharges  in  which  lumps  of  curd  are  seen, 
indicating  that  digestion  is  imperfectly  performed. 
After  awhile,  an  irritation  of  the  intestinal  canal  arises 
from  the  contact  of  hard,  undigested  curds  which  should 
have  been  digested  in  the  stomach,  and  the  discharges 
become  more  offensive  in  character,  and  are  likely  to 
contain  considerable  mucus  from  catarrh  of  the  bowels. 
Clay-colored  stools  indicate  an  inactive  condition  of  the 
liver,  or  an  obstruction  of  the  bile  ducts,  probably  in 
consequence  of  the  extension  of  the  intestinal  catarrh 
into  the  bile  ducts.  When  the  stools  continue  greenish, 
sour,  or  fetid,  the  child  sometimes  shows  marked  symp- 
toms of  wasting,  becoming  thin  and  wrinkled, —  the 
countenance  wearing  an  old  look,  —  weak,  peevish,  and 
restless.  In  many  cases,  the  child  has  convulsions  in 
consequence  of  its  weakened  state,  and  sometimes  dies 
in  one  of  them.  In  other  cases,  it  dies  from  exhaustion. 
When  vomiting  is  the  principal  symptom,  the  difficulty 
frequently  increases  until  the  little  sufferer  is  unable  to 
retain  anything  upon  its  stomach.  • 

The  chief  causes  of  infantile  dyspepsia  are,  over- 
feeding, the  use  of  unclean  bottles  or  of  stale  or  unster- 
ilized  milk  for  bottle-fed  babies,  improper  food,  and 


TREATMENT    OF    DYSPEPSIA.  273 

errors  in  diet  or  ill  health  on  the  part  of  the  mother 
during  the  nursing  period. 

Treatment. — The  dietary  should  be  adapted  to  the 
age  of  the  child  (Diet  Lists  Nos.  14,  15,  16).  During 
the  attack  a  special  dietary  will  be  required.  If  the 
child  is  six  months  or  more  old,  milk  should  be  with- 
held for  a  few  days,  thin,  well-boiled  barley  or  oat- 
meal gruel  being  substituted.  The  beaten  white  of  effsrs 

o  o  OD 

dissolved  in  water  or  a  thin  gruel  is  also  an  excellent 
diet  in  cases  of  this  sort.  General  tonic  measures  are 
required  (page  333),  and  the  other  measures  recom- 
mended for  relief  of  slow  digestion  (page  245). 

An  Important  Caution. —  It  is  of  great  im- 
portance to  recollect  that  the  special  directions  for  the 
diet  in  different  forms  of  dyspepsia  here  given  are  not 
intended  as  rules  to  be  followed  for  any  great  length  of 
time.  In  many  cases  it  is  necessary  to  adhere  strictly 
to  the  special  dietary  only  for  a  few  days,  when  it  may 
by  degrees  be  made  to  include  a  larger  variety  of  foods. 
This  fact  must,  however,  be  impressed  upon  the  mind  of 
the  dyspeptic,  that  when  he  finds  himself  well  again, 
he  must  not  make  the  error  of  supposing  that  the  prin- 
ciple "once  in  grace,  always  in  grace  "  in  any  sense  or 
in  the  smallest  degree  applies  to  the  improved  state  of 
his  digestion.  Although  the  stomach  may  be  restored 
to  a  sufficient  degree  of  health  and  vigor  to  enable  it  to 
do  its  duty  well  under  favorable  circumstances,  it  will 
be  certain  to  relapse  into  a  diseased  state  again  as  soon 
as  those  conditions  are  no  longer  supplied.  The 
dyspeptic  must  make  up  his  mind  to  study  carefully  the 
laws  of  good  digestion,  and  apply  them  to  his  own  case, 


274  THE    STOMACH. 

not  only  as  a  means  of  recovering  his  health,  but  as  an 
essential  for  keeping  well  when  he  has  recovered. 
When  the  stomach  has  once  lost  its  natural,  healthy 
tone,  it  will  never  again  bear  the  degree  of  abuse  which 
it  may  have  endured  for  a  considerable  time  before 
breaking  down. 

In  the  treatment  of  dyspepsia,  attention  to  the 
principles  of  hygiene  and  the  application  of  hygienic 
remedies  are  of  first  importance.  Indeed,  it  is  by  these 
agents  that  nature  is  aided  in  her  restorative  work  more 
than  by  any  others,  and  upon  these  the  most  skilful  and 
successful  of  those  who  have  given  great  attention  to  the 
treatment  of  the  functional  diseases  of  the  stomach  find 
it  safest  to  rely.  Undoubtedly  there  are  cases  which 
may  be  benefited,  and  the  work  of  cure  hastened,  by 
the  employment  of  medicinal  agents  ;  nevertheless,  the 
abuse  of  drugs  is  so  very  great,  and  has  been  the  direct 
cause  of  so  many  cases  of  confirmed  dyspepsia,  that  it 
would  seem  far  better  to  do  without  them  altogether 
than  to  use  them  as  they  are  frequently  employed.  An 
eminent  writer  on  this  subject,  in  referring  to  the  treat- 
ment of  dyspepsia,  says,  "My  main  object  in  the 
treatment  is  to  prevent  the  sufferers  from  resorting 
to  drugs,  which  in  such  cases  not  only  produce  their 
own  morbid  conditions,  but  also  confirm  those  already 
existing. ' '  * 

The  extensive  and  often  habitual  use  of  alkalies  for 
acidity,  of  purgatives  for  constipation,  nervines  and 
opiates  for  sleeplessness,  and  ' '  after-dinner  pills  ' '  to 
goad  into  action  the  lagging  stomach,  has  been  a  potent 
factor  in  the  production  of  a  large  class  of  most  inveter- 
ate dyspepsias.  This  sort  of  treatment  for  dyspepsia 
*  Chambers, 


TKEATMENT   OF   DYSPEPSIA.  275 

cannot  be  too  much  discouraged.  Especially  to  be  dis- 
countenanced is  the  wholesale  employment  of  ' '  liver 
pills,"  "stomach  tonics,"  "anti-bilious  pills,"  "bit- 
ters," and  the  entire  genus  of  quack  nostrums  and 
proprietary  drugs. 

Chronic  Catarrh  of  the  Stomach. —  The 
symptoms  of  chronic  gastric  catarrh  are  pressure  and 
fulness  at  the  stomach  after  eating,  flatulence,  heart- 
burn, little  or  no  appetite,  vomiting,  water-brash,  ten- 
derness at  the  pit  of  the  stomach,  slimy  tongue,  bad 
taste  in  the  mouth,  obstinate  constipation,  occasional 
jaundice,  mental  depression,  lassitude,  pains  in  the  face 
and  limbs,  and  sleeplessness. 

The  chief  causes  of  gastric  catarrh  are  chronic  indi- 
gestion, the  use  of  flesh  food,  hasty  eating,  overeating, 
the  use  of  condiments,  alcoholic  liquors,  tea,  and  cof- 
fee—  in  fact,  whatever  tends  to  excite,  irritate,  or  in- 
terfere with  the  normal  functions  of  the  stomach  may 
produce  chronic  gastric  catarrh.  In  this  disease  there 
is  an  abnormal  development  of  microbes,  which,  being 
imbedded  in  the  mucus  which  covers  the  lining  mem- 
brane of  the  stomach,  are  retained  and  attack  the  food, 
giving  rise  to  fermentation,  and  the  consequent  produc- 
tion of  poisonous  substances  which  increase  the  gastric 
irritation  and  catarrh,  and  when  absorbed  into  the  sys- 
tem, give  rise  to  the  great  variety  of  nervous  symp- 
toms present  in  this  disease. 

Treatment. — Proper  regulation  of  the  diet  is  the 
most  important  measure.  Coarse  foods  must  be 
avoided  when  there  is  much  local  irritation,  the  diet 
being  restricted  to  well-disintegrated  foods.  An  asep- 
tic diet,  and  in  severe  cases  a  liquid  diet  —  exclud- 


276  THE    STOMACH. 

ing,  however,  milk  (unless  in  the  form  of  kumyzoon, 
kumyss,  or  buttermilk),  beef  tea,  and  meat  broths  of 
every  description  —  must  be  employed  for  a  consid- 
erable length  of  time.  Condiments  must  be  avoided, 
as  well  as  all  exciting  food  substances,  together  with 
tea  and  coffee,  and  alcoholic  liquors  in  every  form. 
The  treatment  to  be  employed  is  the  same  as  that 
recommended  for  "Bilious  Dyspepsia"  (page  251),  a 
frequent  precursor  of  this  disease.  The  moist  abdomi- 
nal bandage  (9)  worn  at  night ;  the  hot  and  cold 
trunk  pack  daily  (8)  ;  the  daily  cool  morning  sponge 
bath  (1)  ;  lavage  of  the  stomach  (46)  two  or  three 
times  a  week,  if  necessary  to  remove  accumulated  mu- 
cus or  to  suppress  fermentation  ;  the  graduated  enema 
(24-)  when  constipation  exists  ;  and  all  measures  for 
the  improvement  of  the  general  health  which  have  been 
mentioned  elsewhere  in  this  work,  are  the  most  reliable 
means  of  combating  this  disease. 

"General  Tonic  Treatment"  (page  333)  should  be 
employed,  beginning  with  ' '  .Nutritive  Treatment ' '  in 
the  case  of  feeble  patients. 

Ulcer  of  the  Stomach. —  The  symptoms  of 
ulcer  of  the  stomach  are  pain  in  the  stomach  and  in 
the  spine  opposite  the  stomach,  increased  by  taking 
food,  especially  hot  drinks  and  sugar  ;  tenderness  of 
the  abdomen,  particularly  over  the  stomach  ;  violent 
beating  at  the  pit  of  the  stomach  ;  vomiting  ;  ulcerated 
and  furred  tongue  ;  often  great  thirst ;  constipation. 

Ulcer  of  the  stomach  is  a  much  more  common  dis- 
ease than  is  generally  supposed.  Many  cases  thought 
to  be  merely  neuralgia  of  the  stomach  are  really  chronic 
ulcer,  the  two  diseases  being  very  easily  confounded. 


TREATMENT    OF    DYSPEPSIA.  277 

The  ulcer  may  be  very  small  in  size,  not  more  than  one 
fourth  of  an  inch  in  diameter,  or  it  may  extend  until  it 
becomes  as  large  as  the  palm  of  the  hand.  Sometimes 
the  ulcer  encircles  the  stomach  like  a  band. 

The  chief  causes  of  ulceration  of  the  stomach  are 
the  use  of  condiments  and  other  exciting  foods,  the  ex- 
cessive use  of  meat,  the  use  of  alcoholic  liquors,  over- 
eating, hasty  eating,  and  hyperpepsia  (page  264).  It 
sometimes  results  from  gastric  catarrh. 

Treatment. —  In  severe  cases  the  stomach  should 
be  given  absolute  rest,  the  patient  being  kept  in  bed, 
and  nourished  by  nutritive  enemata  for  some  days. 
After  a  week  or  two  a  liquid  diet  may  be  employed, 
the  patient  being  given  only  very  small  quantities  of 
food  at  intervals  of  three  or  four  hours.  The  liquid 
diet  should  be  adhered  to  for  some  weeks,  until  all  the 
symptoms  have  disappeared.  The  severe  pain  of  ul- 
ceration may  be  greatly  relieved  by  fomentations.  In 
some  instances  ten  or  fifteen  grains  of  soda  taken  just 
before  eating  afford  relief  by  decreasing  the  acidity  of 
the  gastric  juice.  In  cases  of  ulceration  of  the  stomach 
in  which  dilatation  exists,  the  stomach-tube  may  some- 
times be  used  to  advantage  (46)  when  fermentation 
is  present,  but  it  must  be  employed  with  very  great  care. 
Salt  should  be  omitted  from  the  solution  used  in  wash- 
ing out  the  stomach.  The  measures  elsewhere  recom- 
mended for  hypopepsia  (page  260)  should  be  employed, 
in  addition. 

Cancer  of  the  Stomach. —  The  symptoms  of 
cancer  of  the  stomach  are  pain  at  the  pit  of  the  stomach 
of  a  burning  or  gnawing  character,  increased  by  food  ; 
tenderness  to  pressure  over  the  stomach  ;  nausea  and 


278  THE    STOMACH. 

frequently  vomiting,  the  vomited  matters  often  resem- 
bling coffee  grains  ;  hard,  pulsating  tumor  felt  near  the 
pit  of  the  stomach  ;  great  emaciation  ;  tawny  yellow 
complexion  ;  symptoms  of  enlargement  of  the  stomach  ; 
great  exhaustion  ;  swelling  of  the  ankles  ;  sometimes 
general  dropsy. 

Cancer  of  the  stomach  is  one  of  the  most  frequent 
forms  of  malignant  disease.  Recent  researches  seem 
to  show  that  cancer  is  a  parasitic  disease.  Like  other 
parasitic  maladies,  cancer  does  not  attack  a  healthy 
organ,  but  only  one  which  has  become  weakened  by 
abuse.  The  use  of  alcoholic  liquors  and  chronic  indi- 
gestion are  doubtless  predisposing  causes  of  cancer. 
The  disease  itself  is  not  hereditary,  but  the  predisposi- 
tion to  it  is.  Cancer  of  the  stomach  frequently  occurs 
subsequently  to  cancer  in  other  organs  of  the  body. 

Treatment. —  This  disease  is  practically  incurable. 
By  careful  treatment,  however,  much  can  be  done  to 
prolong  the  patient's  life.  The  same  measures  should 
be  employed  as  have  been  recommended  for  chronic 
catarrh  of  the  stomach,  ulcer  of  the  stomach,  and  dila- 
tation. Dilatation  of  the  stomach  occurs  in  cases  of 
cancer  in  which  the  disease  attacks  the  pyloric  portion 
of  the  organ,  thus  causing  obstruction  at  the  outlet  of 
the  stomach.  The  disease  is  greatly  aggravated  by  the 
use  of  meat.  An  aseptic  dietary  (Diet  List  No.  1) 
is  always  indicated.  When  a  state  of  ulceration  is 
reached,  the  diet  must  be  wholly  liquid  in  character, 
and  the  treatment  should  be  such  as  has  been  elsewhere 
recommended  for  "  Ulcer  of  the  Stomach  "  (page  276). 
"  General  Nutritive  Treatment"  (page  331)  should  be 
employed. 


TREATMENT    OF    DYSPEPSIA.  279 

Constipation.  —  The  causes  of  this  exceedingly 
common  condition  are  very  numerous.  Some  of  the 
most  frequent  may^  be  enumerated  as  follows  :  — 

1.  Prolapse  of  the  bowels,   a  condition  in  which 
the  stomach  is  usually  involved,  is  the  cause  of  chronic 
inactivity  of  the  bowels  in  a  very  large  number  of  cases, 
especially  among  elderly  people.     The  usual  causes  of 
prolapsed  bowels  are  two  :  — 

(1)  Tight-lacing  from  corset-wearing  or  the  pressure 
of  tight  bands,  in  women  ;  or  from  wearing  belts,   a 
practise    not   uncommon   among   soldiers   and   certain 
classes  of  laborers,  in  men. 

(2)  A  relaxed  condition  of  the  abdominal  muscles, 
common  in  both  sexes,  but  most  frequent  in  women,  be- 
ing the  result  of  improper  dress,  a  sedentary  life,  or  in- 
attention to  the  proper  attitudes  in  sitting,  standing,  and 
walking.     When  the  large  intestine  becomes  prolapsed, 
it  is  not  infrequently  folded  upon  itself,  producing  a 
sort  of  pseudo-stricture,  so  that  the  fecal  matters,  de- 
tained in  their   passage   along   the   intestine,   become 
hardened,  and  accumulate. 

2.  Dilatation  of  the  large  intestine  is  usually  the 
result   of   overaccumulation   of    fecal   matters,    but   is 
sometimes  caused  by  abnormal   fermentations.       This 
condition  may  be  the  result  of  the  preceding,  as  the 
pressure  of  vigorous  abdominal  muscles  is  necessary  to 
prevent  overaccumulation  of  gas,   and  to  support  the 
thin  walls  of  the  intestines.     It  is  quite  likely,  how- 
ever, to  result  from  neglect  to  empty  the  bowels  regu- 
larly.     When  overaccumulation  has  been  allowed  to 
exist  habitually  for  some  months  or  years,   the  walls 
of  the   intestines   may  become  so  stretched  that  their 


280  THE    STOMACH. 

natural  muscular  activity  is  gone,  and  can  never  be 
recovered,  although  some  improvement  may  be  secured 
by  proper  treatment.  This  condition  is  common  in 
both  sexes,  but  is  more  frequent  in  women,  and  is  the 
direct  result  of  improper  dress  and  sedentary  habits. 

3.  Dilatation  of  the  stomach,   a  condition  exceed- 
ingly common  in  persons  suffering  from  dyspepsia,  and 
existing  in  fully  one  half  of  all  cases  of  this  kind,  some- 
times  becomes  a  cause  of   constipation  by  provoking 
intestinal   catarrh   through   the   irritating   influence  of 
fermented  and  improperly  digested  substances,  which, 
after  a  long  delay,  escape  from  the  stomach  into  the 
intestine. 

4.  General   weakness   and   relaxation  of  the  mus- 
cular system  of  the  body  may  induce  a  similar  condi- 
tion of  the  intestinal  muscles,  resulting  in  constipation 
from   deficient   peristaltic   activity ;    hence  exhausting 
labor   or,  in  fact,   anything  which  exhausts  the  nerve 
centers,  may  give  rise  to  intestinal  sluggishness. 

5.  A  torpid  liver,  by  which  is  meant  a  liver"  which 
does  not  secrete  a  sufficient  quantity  of  bile,  may  be  the 
cause  of  constipation.    Bile  is  a  natural  laxative,  serving 
to  stimulate  the  muscular  contraction  of  the  intestinal 
walls.     When  lacking  in  quantity,  deficient  intestinal 
activity  is  a  natural  result.     Anything  which  clogs  the 
liver,  or  renders  it  inactive,  may  be  a  cause  of  consti- 
pation.    The  use  of  animal  food,  condiments,  tea  and 
coffee,  and  an  excessive  amount  of  sweets  and  fats, 
must  all  be  considered  as  productive  of  constipation, 
through  their  influence  upon  the  liver. 

6.  Hemorrhoids  may  be  a  cause  of  intestinal  inac- 
tivity, acting  mechanically  to  prevent  complete  evacua- 


TREATMENT    OF    DYSPEPSIA.  281 

tion  of  the  bowels,  and  to  cause  a  retention  and  harden- 
ing of  fecal  matter.  The  number  of  persons  who  carry 
about  with  them  constantly  considerable  quantities  of 
hardened  fecal  matters  in  the  large  intestine,  must  be 
very  great,  judging  from  the  results  of  treatment  in 
dislodging  old  accumulations  of  this  sort  in  cases  which 
have  come  under  the  writer's  care.  In  some  cases, 
great  quantities  of  black  and  decomposing  matter  have 
been  discharged  after  two  or  three  weeks,  during  which 
time  the  patient's  bowels  had  been  daily  washed  out 
with  two  or  three  quarts  of  warm  water  applied  in  the 
most  thorough  manner  possible. 

7.  Rectal  ulcer,  catarrh  of  the  rectum,  and  an  irri- 
table rectum  resulting  in  spasmodic  contractions  of  the 
muscles  which  close  the  lower  end  of  the  bowel,  some- 
times induce  constipation  by  presenting  too  great  resist- 
ance to  the  expulsive  effort  by  which  the  fecal  matters 
are  discharged  from  the  body,  so  that  the  bowel  is  never 
completely  emptied,  and  the  accumulations  thus  begun 
are  gradually  increased. 

8.  A  loss  of  natural  sensibility  in  the  mucous  mem- 
brane of  the  rectum  is  doubtless  a  frequent  cause  of 
constipation.     This  semi-paralyzed  condition  is  usually 
due  to  failure  to  evacuate  the  bowels  at  a  regular  time. 
After   long    neglect   of    this   sort,    the   natural   reflex 
activities  by  which  the   bowels   are   stimulated  to  ex- 
pulsive  action  are  no   longer   awakened  by  the  pres- 
ence of  fecal  matters  in  the  rectum  ;  and  constipation 
is  the  result. 

9.  Another  cause  of  constipation  is  excessive  dry- 
ness  of  the  fecal  matters,  which  prevents  their  ready 
movement  along  the  large  intestine.     This  is  usually 


282  THE    STOMACH. 

the  result  of  too  long  retention  within  the  lower  bowel, 
but  may  result  from  other  causes,  as  a  feverish  condi- 
tion, or  from  a  deficient  secretion  of  the  mucus  which 
acts  as  a  lubricant. 

10.  Many  persons  are  suffering  from  chronic  con- 
stipation as  the  result  of  "orificial  surgery."  The 
rectum  not  only  contains  pockets  in  which  a  quantity  of 
mucus  is  formed  for  the  purpose  of  lubricating  the  fecal 
mass  as  it  is  expelled  from  the  body,  but  a  fringe  of 
papillaa  is  also  found  in  the  healthy  rectum  just  within 
the  anal  orifice.  These  papillae  are  connected  with 
nerves,  the  function  of  which  is  to  bring  forcibly  and 
involuntarily  into  action  at  just  the  right  moment  the 
strong  muscles  of  the  abdominal  walls,  so  as  to  accom- 
plish complete  evacuation  of  the  bowels.  These  pock- 
ets and  papillae  were  discovered  by  Professor  Homer, 
the  eminent  anatomist  of  Philadelphia,  who  described 
and  pictured  them  in  his  "  Anatomical  Atlas  "  nearly 
half  a  century  ago.  The  "orificial  "  surgeon  often  in- 
dustriously trims  off  every  papilla,  and  slits  up  every 
pocket,  for  no  other  reason,  apparently,  than  to  line  his 
own  pockets,  and  certainly  to  the  great  disadvantage  of 
the  patient,  who,  with  his  rectum  thus  maimed,  has  lost 
two  important  links  in  the  chain  of  automatic  activities 
by  which  nature  secures  a  daily  evacuation  of  the 
bowels. 

Treatment. — Any  course  of  treatment,  to  be  cura- 
tive of  this  condition,  must  take  into  consideration  all 
the  various  possible  causes  which  may  have  brought 
about  the  intestinal  inactivity  in  any  particular  case. 
It  is  necessary  also,  not  only  to  remove  these  causes, 
but  to  repair,  so  far  as  possible,  by  the  application  of 


TREATMENT    OF    DYSPEPSIA.  283 

efficient  means,  the  damage  which  has  been  wrought  by 
wrong  habits  and  morbid  influences. 

The  matter  of  first  importance  in  the  treatment  of 
constipation  is  the  diet.  The  abundant  use  of  fruit  is 
one  of  the  most  excellent  means  of  preventing  and 
curing  this  disease.  One  or  two  oranges  before  break- 
fast ;  a  couple  of  apples  at  breakfast ;  the  free  use  of 
steamed  figs,  stewed  prunes,  and  other  fruits,  are  means 
to  be  recommended  in  nearly  all  cases  of  chronic  con- 
stipation. There  are,  of  course,  some  cases  in  which 
fruits  must  be  avoided.  In  these  cases  coarse  grains  — 
cracked  wheat,  oatmeal,  graham  or  bran  bread,  bran 
cakes,  etc. —  serve  a  useful  purpose.  Peas,  beans, 
lentils,  asparagus,  green  peas,  string  beans,  and  similar 
vegetables  which  are  easy  of  digestion,  but  which  con- 
tain a  considerable  amount  of  woody  or  indigestible 
substance,  may  also  be  advantageously  used.  Coarse 
vegetables,  however,  must  be  avoided  in  cases  where 
there  is  marked  dilatation  of  the  stomach.  Granose, 
gofio,  and  other  excellent  health  foods  manufactured  by 
the  Battle  Creek  Sanitarium  Health  Food  Co.,  Battle 
Creek,  Mich.,  have  proved  of  very  great  value  to 
thousands  of  persons  suffering  from  this  condition. 
Granose  (Diet  List  No.  25),  a  new  health  food  recently 
perfected,  is  especially  valuable  as  a  food-cure  for  con- 
stipation, if  freely  used.  Most  persons  are  very  promptly 
relieved  by  its  use.  Bromose  (Diet  List  No.  25),  an- 
other new  health  food,  is  also  found  to  be  a  very  ex- 
cellent remedy  in  these  cases. 

A  glass  of  cold  water  before  breakfast  is  a  prescrip- 
tion which  has  cured  many  cases  of  constipation.  The 
free  use  of  water,  either  hot  or  cold,  taken  one  or  two 


284  THE    STOMACH. 

hours  before  each  meal,   is  a  valuable  remedy.      (See 
Diet  List  No.  21.) 

Exercises  of  various  kinds,  particularly  such  as 
bring  into  active  play  the  muscles  of  the  lower  part  of 
the  trunk,  are  essential  in  the  treatment  of  many  < 
of  intestinal  inactivity.  Walking  three  to  five  miles  a 
day  is  sufficient  to  secure  regularity  of  the  bowels  in 
many  persons.  A  short  walk  before  breakfast  is  espe- 
cially helpful. 

The  exercises  of  the  Ling  system,  known  as  Swedish 
gymnastics,  have  been  found  of  special  value  in  the 
treatment  of  this  class  of  cases  at  the  Battle  Creek 
Sanitarium  (43).  Horseback  riding,  rowing,  and  bi- 
cycle riding  are  also  very  helpful. 

Massage  of  the  bowels  (29,  30),  Swedish  move- 
ments (43),  the  wet  girdle  (9),  applications  of  elec- 
tricity to  the  abdomen  (66,  69),  and,  in  special  cases, 
to  the  abdomen  and  rectum,  are  measures  of  great  im- 
portance. The  liver  douche  (20)  and  the  hot  and  cold 
full  bath  (21)  may  also  be  employed.  General  tonic 
measures  (page  333)  are  essential  as  means  of  reinforc- 
ing the  general  nervous  energy.  In  cases  of  prolapse 
of  the  bowels,  the  abdominal  supporter  (45)  should 
be  worn. 

Introduction  into  the  rectum  of  a  small  quantity  of 
cold  water,  half  a  pint  or  a  pint,  before  breakfast,  to  be 
retained  until  after  breakfast,  is  a  useful  measure.  A 
small,  cold  enema  taken  at  the  regular  time  for  the 
bowels  to  move,  is  better  than  a  large,  warm  one,  as 
it  is  a  more  powerful  stimulant  to  intestinal  activity.  A 
small  amount  of  cold  water  introduced  into  the  rectum  at 
night  upon  retiring,  is  a  useful  measure  in  cases  where 


TREATMENT    OF    DYSPEPSIA.  285 

the  intestinal  contents  are  dry  and  hard  ;  half  a  pint  or 
a  pint  is  a  sufficient  amount.  In  some  cases  in  which 
the  stools  are  large  and  the  rectum  irritable,  an  ounce 
or  two  of  olive  or  almond  oil  introduced  at  night  or 
before  breakfast  is  a  useful  measure.  Camphor  water, 
consisting  of  three  or  four  ounces  of  water  to  half  a 
teaspoonful  of  spirits  of  camphor,  may  be  introduced 
into  the  rectum  before  breakfast  with  advantage  in 
many  cases.  Some  cases  are  relieved  by  the  introduc- 
tion of  a  small  quantity  of  glycerin, —  two  or  three 
tablespoonfuls  with  an  equal  quantity  of  water, —  al- 
though sometimes  pure  glycerin  may  be  necessary. 
Two  or  three  trials  will  determine.  Suppositories  made 
of  glycerin  or  glycerin  and  camphor  are  also  valuable 
for  the  same  purpose  ;  they  may  be  introduced  either 
at  night  or  before  breakfast,  or  at  both  times. 

When  the  rectum  is  the  seat  of  catarrh,  a  mixture 
consisting  of  equal  parts  of  starch  and  boracic  acid, 
introduced  by  means  of  a  proper  instrument,  is  a  very 
helpful  measure.  The  use  of  equal  parts  of  boracic 
acid  and  subcarbonate  of  bismuth,  or  subcarbonate  of 
bismuth  alone,  is  preferable  when  there  is  an  unusual 
degree  of  irritation.  The  introduction  of  a  dram  or 
two  of  boracic  acid  into  the  rectum  daily  before  break- 
fast, is  a  most  valuable  remedy,  and  one  which  is  often 
found  curative  of  this  condition. 

It  must  not  be  forgotten  that  regularity  in  attending 
to  the  demands  of  nature  is  a  matter  of  the  utmost  con- 
sequence in  these  cases,  both  as  a  preventive  and  a 
curative  measure.  Sometimes  the  inability  to  evacuate 
the  bowels  is  due  to  weakness  of  the  abdominal  mus- 
cles ;  in  such  cases  it  may  be  necessary  to  aid  the  bowels 


286  THE    STOMACH. 

by  pressure  of  the  hands.  Several  cases  have  come 
under  the  author's  care  in  which  there  was  inability  to 
evacuate  the  bowels  when  sitting  in  the  usual  position, 
but  no  difficulty  when  a  crouching  position  was  as- 
sumed. This  was  doubtless  due  to  the  increased  pres- 
sure brought  to  bear  upon  the  abdominal  contents  when 
sitting  in  a  crouched  position. 

Some  cases  of  constipation  tax  the  skill  and  ingenu- 
ity of  the  physician  to  the  utmost,  and  cannot  be  re- 
lieved by  the  simple  measures  which  can  be  undertaken 
at  home.  There  is  now  and  then  a  case  in  which  ex- 
treme dilatation  of  the  colon  exists,  so  that  this  organ 
entirely  loses  its  power  to  contract  upon  itself,  and 
becomes  little  more  than  a  lifeless  sac.  In  such  cases 
constant  use  of  the  enema  (22)  or  coloclyster  is  the 
only  means  by  which  the  bowels  can  be  relieved,  and 
this  measure  must  be  employed  habitually. 

There  is  no  one  remedy  for  constipation  so  valuable 
in  all  cases  as  a  diet  consisting  chiefly  of  granose,  fruits, 
and  nuts  or  bromose  (Diet  List  No.  25). 


REMEDIES  FOR  THE  HOME  TREAT- 
MENT  OF  DYSPEPSIA. 


IN  the  majority  of  cases  of  chronic  dyspepsia  the 
patient  is  more  or  less  permanently  disabled,  and  hence 
needs  to  be  made  familiar  with  measures  of  treatment 
which  he  can  himself  employ  at  home,  since  he  cannot 
have  a  physician  or  nurse  always  with  him,  and  cannot 
live  continually  at  a  sanitarium.  There  is  no  way  in 
which  the  chronic  sufferer  from  indigestion  can  so  well 
accomplish  this  object  as  by  placing  himself  for  a  few 
months  under  treatment  at  a  thoroughly  equipped  and 
rationally  conducted  sanitarium.  In  such  cases  health 
is  to  be  obtained  only  by  a  long  and  persevering  course 
of  correct  regimen  and  careful  health  culture  and  train- 
ing, which,  in  order  to  secure  the  best  results,  requires 
the  personal  supervision  of  a  skilled  physician  and  of 
trained  assistants  in  carrying  out  the  necessary  treat- 
ment. As  it  is  impossible,  however,  that  all  should 
enjoy  these  advantages,  the  writer  has  undertaken  to 
describe  such  measures  of  treatment  as  extensive  obser- 
vation and  study  in  the  hospitals  of  this  country  and 
Europe,  and  many  years'  experience  in  the  treatment 
of  various  forms  of  digestive  disorders,  has  led  him  to 
consider  most  efficient  and  best  adapted  for  employ- 
ment at  home. 

Before  beginning  a  course  of  treatment,  the  patient 
should  read  carefully  the  chapter  on  ' '  Symptoms, ' '  and 
19  [287] 


288  THE    STOMACH. 

make  up  his  mind  as  to  the  form  of  dyspepsia  from 
which  he  is  suffering.  The  diagnosis  being  determined, 
he  should  give  careful  attention  to  the  prescription  for 
the  treatment  of  the  particular  form  of  dyspepsia  from 
which  he  is  suffering,  and  should  arrange  his  diet,  pro- 
gram of  treatment,  and  whole  course  of  life  with  refer- 
ence to  the  requirements  of  his  malady,  no  matter  how 
inconvenient  it  may  be  to  do  so.  Nothing  less  than 
thorough  measures  will  accomplish  anything  in  the 
treatment  of  this  disease. 

It  must  be  remembered,  also,  that  a  malady  which 
has  been  acquired  as  the  result  of  long  years  of  trans- 
gression of  the  laws  of  health,  cannot  be  overcome  by 
a  few  days  or  even  a  few  weeks  of  treatment.  Many 
months  of  persevering  effort  are  usually  required  to 
secure  permanent  and  favorable  results,  although  it  is 
just  and  proper  to  expect  some  immediate  amelioration 
of  distressing  symptoms  when  they  exist. 

Not  infrequently  there  is  a  slight  exaggeration  of 
symptoms  at  the  beginning  of  treatment,  and  sometimes 
new  symptoms  make  their  appearance.  There  is  often 
a  slight  or  even  a  considerable  loss  of  flesh  for  a  short 
time.  Any  aggravation  of  symptoms  should  be  care- 
fully considered.  The  cause  may  be  a  mistake  in  diag- 
nosis, incorrect  application  of  the  treatment,  or  some 
individual  idiosyncrasy  which  must  be  taken  into  con-, 
sideration.  As  a  rule,  any  measure  of  treatment  or 
regimen  which  aggravates  symptoms  should  be  at  once 
discontinued. 

A  reasonable  amount  of  good  judgment  and  com-, 
mon  sense  must  be  employed  in  connection  with  the 
treatment  recommended  in  order  for  it  to  bg  fully  effect- 


HOME   TREATMENT   OF    DYSPEPSIA.  289 

ive.  Most  of  the  measures  described  in  the  following 
paragraphs  are  designated  by  numbers,  for  convenience 
of  reference  :  — 

1.  The  Sponge -or  Hand  Bath.  —  Soft  water, 
a  soft  sponge  or  a  linen  or  cotton  cloth,  and  one  or  two 
soft  towels  or  a  sheet,  are  the  requisites.  The  hand 
may  be  used  in  the  absence  of  a  cloth  or  a  sponge  for 
applying  the  water.  For  a  saline  sponge  bath  add  a 
tablespoonful  of  salt  to  a  quart  of  water.  One  part  of 
vinegar  may  be  added  to  three  parts  of  water  for  a 
vinegar  sponge  bath. 

The  temperature  of  the  bath  should  not  be  above 
92°  F.,  and  85°  is  generally  better.  Most  people  can 
habitually  employ  a  temperature  of  75°  or  80°  F.  with- 
out injury,  and  some  receive  most  benefit  from  a  still 
lower  temperature.  The  use  of  a  much  lower  tempera- 
ture is  not  commonly  advisable,  however,  and  is  often 
productive  of  great  injury. 

Begin  the  bath  by  wetting  the  head.  Bathe  the 
face,  then  the  neck,  chest,  shoulders,  arms,  trunk,  and 
back.  Rub  vigorously  until  the  skin  is  red,  to  prevent 
chilling  ;  for  even  when  the  temperature  of  the  room  is 
nearly  equal  to  that  of  the  body,  the  rapid  evapora- 
tion of  water  from  the  surface  will  lower  the  exter- 
nal temperature  very  rapidly,  unless  a  vigorous  circula- 
tion is  maintained. 

After  thoroughly  bathing  the  upper  part  of  the 
body,  turn  the  attention  to  the  lower  portion,  continu- 
ing the  rubbing  of  the  upper  part  at  brief  intervals  to 
prevent  chilliness.  As  soon  as  the  bathing  is  con- 
cluded, envelop  the  body  in  a  sheet  and  rub  dry,  or 
dry  the  skin  with  a  towel.  When  the  surface  is  nearly 


290  THE    STOMACH. 

or  quite  dry,  rub  the  whole  body  vigorously  with  the 
bare  hand. 

The  bath  should  not  be  prolonged  more  than  ten  or 
fifteen  minutes.  Five  minutes  is  a  sufficient  time  to 
secure  all  the  benefits  of  the  bath,  and  even  three 
minutes  will  suffice. 

Persons  who  chill  easily  will  find  it  better  to  bathe 
only  a  small  portion  of  the  body  before  drying  it. 
Some  persons  will  even  find  it  necessary  to  retain 
some  of  the  clothing  upon  the  lower  part  of  the  body 
while  bathing  and  drying  the  upper  part. 

This  bath  may  be  given  to  a  feeble  patient  with  very 
little  disturbance,  even  in  bed.  Only  a  small  portion 
of  the  body  should  be  uncovered  at  one  time,  that  being 
bathed,  dried,  and  rubbed,  and  then  covered  while 
another  part  is  treated  in  a  similar  manner. 

2.  The  Full  Bath. —  This  bath  is  taken  in  an 
ordinary  bath-tub,  which  should  contain  water  enough 
to  cover  the  body.  For  a  hot  bath  a  temperature  of 
100°  to  105°  F.  should  be  employed  ;  for  a  warm  bath, 
90°  to  95°  F.  When  employed  for  eliminative  pur- 
poses, the  bath  should  be  continued  until  the  patient 
perspires  gently.  A  full  bath,  accompanied  by  the  use 
of  soap  and  the  flesh-brush,  is  especially  useful  as  a 
cleansing  bath.  Care  should  be  taken  to  lower  the 
temperature  of  the  bath  fifteen  or  twenty  degrees  just 
at  its  conclusion,  to  prevent  the  patient  fro*m  taking 
cold.  The  body  should  be  thoroughly  dried  after  the 
bath  in  this  as  in  all  other  baths.  In  cold  weather, 
oil  should  be  applied  after  the  use  of  soap,  to  lessen 
the  danger  of  taking  cold. 


HOME    TREATMENT    OF    DYSPEPSIA. 


291 


3.  The  Salt  Glow.  —  This  is  a  most  excellent 
tonic  bath.  It  consists  essentially  in  rubbing  the  whole 
body  with  moist  salt,  applied  freely  to  the  surface. 
The  bath  should  not  occupy  more  than  three  to  five 
minutes.  The  salt  should  be  rinsed  off  by  pouring  a 


FIG.  19.— SHOWER  BATH. 

pail  of  water  over  the  patient,  by  a  shower  bath,  or  by 
sponging. 

4.  The  Shower  Bath. — An  apparatus  such  as 
is  indicated  in  Fig.  19  is  the  most  convenient  for  this 
bath,  but  water  poured  through  an  ordinary  colander, 
or  the  simple  device  shown  in  Fig.  20  may  be  employed. 


292 


THE    STOMACH. 


This  consists  of  a  vessel  with  a  perforated  bottom,  fur- 
nished with  a  hollow  tube  for  a  handle.  The  vessel  is 
filled  by  immersing  it  in  water,  and  the  thumb  placed 
over  the  end  of  the  handle,  which  prevents  the  water 
from  running  out.  When  the  thumb  is  removed,  the 
water  falls  through  the  perforated  bottom  in  a  shower. 
The  shower  bath  is  usually  administered  cold  or  at  a 
temperature  of  60°  to  80°  F.  It  should  last  but  a  few 
seconds.  This  is  a  most  powerful  tonic  bath.  The 

shower  may  be  applied  to 
the  whole  body,  at  a  single 
point,  as  over  the  region  of 
the  stomach  and  liver,  or  to 
any  portion  of  the  trunk  or 
limbs. 

The 
be   60° 
effects, 
shower 
properly 


temperature  should 
to  80°  F.  for  tonic 
In  taking  a  general 
bath,  the  patient, 
prepared,  begins 
the  bath  by  placing  one  hand 
FIG.  20,-SiMPLE  SHOWER  BATH.  Or  one  foot  under  the  shower, 
and  then  quickly  passing  one  arm  under  to  the  shoulder, 
then  the  other  arm,  allowing  the  water  to  fall  upon  the 
chest,  then  upon  the  back,  and  so  on  until  the  whole 
surface  has  been  exposed  to  the  direct  force  of  the 
stream. 

5.  The  Rubbing  Wet-Sheet.—  This  is  a  very 
valuable  means  of  stimulating  the  skin,  and,  through 
it,  the  central  nervous  system  ;  indeed,  it  is  one  of  the 
best  of  all  tonics.  The  patient,  standing,  is  quickly 
wrapped  with  a  sheet  wrung  out  of  water  at  a  tempera- 


HOME    TKEATMENT    OF    DYSPEPSIA. 


293 


ture  of  80°  to  90°  F.  for  feeble  patients,  and  a  lower 
temperature  for  stronger  ones.  He  is  then  briskly 
rubbed  outside  the  sheet.  The  sheet  may  be  renewed 
from  one  to  three  times,  according  to  the  strength  of 
the  patient  or  the  intensity  of  the  effect  desired 
(Fig.  21). 

6.  The  Wet-Sheet  Pack. —Two  or  three  com- 
fortables or  thick  blankets,  one  woolen  blanket,  and  a 
large  linen  or  cotton  sheet,  are  the  articles  necessary. 
It  is  important  that  the  sheet 
be  sufficiently  large  to  ex- 
tend twice  around  the  pa- 
tient's body.  Two  or  more 
blankets  are  required  in  cool 
weather  or  by  weak  patients. 
Spread  the  comfortables,  one 
by  one,  upon  a  bed  or 
straight  lounge,  making  them 
even  at  the  top.  Over  them 
spread  the  woolen  blanket, 
allowing  its  upper  edge  to 
fall  an  inch  or  two  below 
that  of  the  last  comfortable. 
Wet  the  sheet  in  water  of  the  proper  temperature,  hav- 
ing gathered  the  end  in  one  hand  so  that  it  can  be 
quickly  spread  out.  Wring  so  that  it  will  not  drip 
much,  place  its  upper  end  even  with  the  woolen  blanket, 
and  spread  it  out  on  each  side  of  the  middle  sufficiently 
to  allow  the  patient  to  lie  down  upon  his  back,  which 
he  should  do  quickly,  letting  his  ears  come  just  above 
the  upper  border  of  the  sheet,  and  extending  his  limbs 
near  together.  Carefully  wrap  the  patient,  first  with 


FIG.  21.— KUBBING  WET-SHEET. 


294  THE    STOMACH. 

the  sheet  and  afterward  with  the  blanket,  taking  pains 
to  exclude  the  air  (Fig.  22). 

7.  The  Trunk  Pack.  —  This  is  administered  in 
the  same  way  as  the  wet-sheet  pack,  with  the  excep- 
tion that  the  application  is  confined  to  the  trunk  of  the 
body. 

8.  The  Hot  and  Cold  Trunk  Pack.  — This 
valuable  measure  is  administered  in  the  same  manner 

as  the  trunk  pack, 
except  that  a  rubber 
bag  two  thirds  full 
of  hot  water  is  placed 

over  the  stomach  be- 
FIG.  23.- WET-SHEET  PACK.  fore  the  col(j   gheet  js 

applied.     A  flannel  cloth   should  be   placed   next  the 
skin  to  prevent  injury  from  the  hot  bag. 

9.  The    Wet    Girdle. — This    was   a    favorite 
remedy  with   the  early  German   hydropathists,   and  it 
is  a  very  useful  appliance   when   properly  employed, 
though  it  has  been  much  abused  by  excessive  use.     To 
apply  it  well,  a  coarse  towel  about  three  yards  long  is 
the  most   convenient.     Wet  one   half  of   this  in  cold 
water,  wring  until  it  will  not  drip,  and  apply  it  to  the 
abdomen,  placing  one  end  at  the  side  and  bringing  it 
across  the  front  first,  so  that  two  thicknesses  of  the  wet 
portion  will  cover  the  abdomen.     After  winding  the 
whole  tightly  around  the  body,  fasten  the  end  securely 
with   pins   or   with  tapes    attached   for   the   purpose. 
Cover  all  with  several  folds  of  flannel. 

In  cold  weather,  the  moistened  towel  should  be 
covered  with  oiled  muslin  before  the  application  of  the 
flannel,  and  care  should  be  taken  to  have  the  dry  wrap- 


HOME    TREATMENT    OF    DYSPEPSIA. 


295 


pings  extend  at  least  two  inches  beyond  the  edges  of 
the  moist  towel,  to  prevent  evaporation  and  chilling. 
The  colder  the  water  in  which  the  towel  is  wrung,  the 
more  vigorous  will  be  the  effect  produced.  For  feeble 
patients  the  towel  should  be  wrung  as  dry  as  possible. 


FIG.  23.— FOMENTATION. 

10.  Fomentation. — Fold  a  soft  flannel  twice, 
so  as  to  make  four  thicknesses.  Dip  in  very  hot  water, 
lifting  out  by  the  corner  and  placing  in  the  middle  of 
a  towel.  Roll  up  quickly  in  the  towel  lengthwise,  and 
wring  nearly  as  dry  as  possible  by  twisting  the  ends  of 
the  towel.  In  this  way  the  fomentation  can  be  wrung 


THE    STOMACH. 


out  much  hotter  than  with  the  hands.  Of  course  it  will 
be  too  hot  to  apply  to  the  bare  flesh  ;  but  the  skin 
should  be  protected  by  one  or 
more  thicknesses  of  flannel,  and 
the  fomentation  applied  at  once, 
and  covered  with  another  dry 
flannel.  Renew  the  fomenta- 
tion when  the  neat  begins  to 
moderate  very  perceptibly,  and 
continue  as  long  as  necessary 
(Fig.  23). 

11.  Mustard  or  Turpen- 
tine Fomentation. —  The  ef- 
fect of  the  fomentation  may  be 
increased  by  adding  a  tablespoon- 
f ul  of  mustard  to  the  water  from 
which  the  fomentation  is  wrung, 
or  by  sprinkling  over  the  fomentation  cloth  when  ready 
to  apply,  an  ounce  of  alcohol  in  which  a  teaspoonful  of 
turpentine  has  been  dissolved. 

12.  Dry  Heat. — Dry  applications  of  heat  may 
be   made  by  means  of  a  rubber  bag   filled   with   hot 

•/ 

water  (Figs.  24,  25),  heated  bricks  wrapped  with  flannel 


FIG.  24.— HOT  WATEH-BAO. 


I-' Mi.  i"). 


cloths,  flannel  bags  containing  hot  salt,  bottles  filled 
with  hot  water,  and  similar  means. 


HOME    TREATMENT    OF    DYSPEPSIA.  297 

13.  The  Foot  Bath.  —  Any  vessel  sufficiently 
large  to  receive  the  feet  and  enough  water  to  cover 
them  to  the  ankles,  is  suitable  for  this  bath.  The  tem- 
perature should  usually  be  100°  to  105°  F.  If  the 
water  is  cold,  it  should  not  be  more  than  one  fourth  of 
an  inch  deep. 

The  alternate  hot  and  cold  foot  bath  is  a  very  valu- 
able remedy  for  cold  feet.  It  is  given  thus  :  Place  the 
feet  in  hot  water  — 100°  to  110°  F.  —  for  two  or  three 
minutes.  Then  withdraw  them,  and  plunge  them 
quickly  into  a  bath  of  cold  water,  60°  F.  or  less. 
After  two  or  three  minutes,  restore  them  to  the  hot 
bath.  Thus  alternate  three  or  four 
times,  and  conclude  by  dipping  the 
feet  quickly  into  the  cold  water  and  wip- 
ing dry.  This  bath  produces  a  most 
powerful  reflex  action  (Fig.  26).  FIG.  26.-FooT  BATH. 

14-.  The  Sitz  or  Hip  Bath.  —  For  this  bath  a 
common  tub  may  be  used,  by  placing  a  support  under 
one  edge  to  elevate  it  two  or  three  inches  ;  but  it  is 
better  to  use  a  tub  made  for  the  purpose,  which  should 
have  the  back  raised  eight  or  ten  inches  higher  than 
the  front,  to  support  the  back  of  the  patient,  and  the 
sides  sloping  gradually  so  as  to  support  the  arms  of  the 
bather.  The  bottom  should  be  elevated  two  or  three 
inches.  The  depth  in  front  should  be  about  the  same 
as  that  of  a  common  wash-tub. 

Enough  water  is  required  to  cover  the  hips  and  ex- 
tend a  little  way  up  on  the  body.  Four  to  six  gallons 
is  about  the  proper  quantity. 

A  very  good  plan  for  administering  this  bath,  and 
one  which  will  be  applicable  to  most  cases,  is  this  : 


298 


THE    STOMACH. 


Begin  the  bath  at  92°  or  93°  F.  If  a  thermometer  is 
not  at  hand,  pour  into  the  bath-tub  three  gallons  of 
fresh  well-  or  spring-water,  and  then  add  one  gallon  of 

boiling  water.  This 
will  give  the  desired 
temperature.  After 
the  patient  has  been 
in  the  bath  ten  min- 
utes, cool  it  down  to 
85°  F.,  which  may  be 
done  by  adding  a 
gallon  of  cold  water. 
Continue  the  bath 
five  minutes  longer  ; 
then  administer  a 
douche  or  spray 


FIG.  27.-THE  SITZ  BATH  TUB. 

at  about  85°  F.,  and  wipe  dry,  as  directed  after  a  hand 
bath  (Fig.  27). 

15.  The  Sun  Bath.  —  The  whole  body,   unpro- 
tected by  clothing,  should  be  exposed  to  the  sun,  the 
head    only  being   covered.     The   exposure   should   be 
from  three   to   fifteen   minutes,  when  a  tepid   sponge 
bath  should  be  administered. 

16.  The  Vapor  Bath.  —  This   excellent    elimi- 
native  bath  may  be  easily  improvised  by  placing  the 
patient  in  a  chair  surrounded  by  thick  coverings,  and 
heating  the  water  in  a  pail  or  small  tub  placed  beneath 
the  chair  by  gradually  lowering  into  it  hot  stones  or 
bricks.     For  permanent  use,  a  wooden  box  may  be  con- 
structed after  the  plan  shown  in  Fig.  28. 

The  skin  of  most  dyspeptics  is  very  inactive,  and 
with,  many  the  perspiration  has  an  offensive  odor.     On 


HOME    TKEATMENT    OF    DYSPEPSIA. 


299 


this  account,  a  short  hot-water  or  vapor  bath  may  be 
taken  once  a  week  with  advantage.  The  bath  should 
be  continued  just  to  the  point  of  inducing  perspiration, 
but  not  longer,  as  warm  baths  are  relaxing  and  debili: 
tating.  A  dash  of  cold  water  over  the  body,  poured 
from  a  pail  or  by  means  of  the  shower,  should  imme- 
diately follow  the  hot  bath.  The  patient  should  then 
be  quickly  dried  and  rubbed,  so  as  to  secure  a  good 
reaction.  Wrapping  in  a  dry  woolen  blanket  promotes 
reaction,  and  is  necessary  in  the  cases  of  some  thin- 
blooded  dyspeptics.  A  full  hot 
bath,  an  improvised  vapor  or  hot- 
air  bath,  or  a  hot-blanket  pack 
may  be  used  as  a  means  of  induc- 
ing gentle  .perspiration.  The  best 
of  all  such  measures,  however,  is 
the  sun  bath  or  the  electric-light 
bath. 

17.  The  Hot-air   Bath.- 

This  is  administered  in  a  manner  similar  to  the  vapor 
bath,  except  that  the  heat  is  produced  by  burning  alco- 
hol in  a  small  dish  placed  for  safety  in  a  vessel  con- 
taining a  little  water.  The  purpose  of  the  hot-air  bath 
is  to  induce  perspiration.  A  cold  shower  or  sponge 
bath  should  be  applied  at  the  conclusion  of  the  bath. 

18.  Heat    and    Cold    to    Spine. — Alternate 
fomentations   and    cold    compresses   may   be   applied, 
or  alternate  hot  and  cold  sponging,  if  it  is  preferred, 
the    alternations    being   made    every   half    minute,    or 
once    in   one   to   three   minutes-      Water    as    hot  and 
as  cold  as  can  be   borne   should   be   used.     In   some 
cases  it  is  necessary  to  employ  ice  in  order  to  obtain 


7 


FIG.  38.— VAPOR  BATH. 


300  THE    STOMACH. 

the  desired  effect.  When  ice  is  applied  to  the  skin, 
the  cold  application  should  occupy  only  five  to  ten 
seconds. 

19.  The    Hot     and    Cold    Pour,    or    Pail 
Douche. — Two  pails  of  water,  one  at  a  temperature 
of  120°  to  130°  F.,  the  other  as  cold  as  can  be  ob- 
tained,—  ice  water  when  a  very  strong   effect  is   de- 
sired,—  and  a  dipper,   are  the  essential  requirements. 
If  the  application  is  to  the  spine,  the  patient  should  sit 
on  the  edge  of  the  tub  while  the  water  is  poured  upon 
the  spine  from  a  dipper.     The  force  of  the  application 
may  be  varied  somewhat  by  the  height  at  which  the 
dipper  is  held.     The  application  should  be  alternated 
every  eight  or  ten  seconds. 

20.  The  Hot  and  Cold   Liver   Douche.  - 
The  patient  lies  in  a  full-bath  tub  while  a  hot  and  cold 
pour   is  administered   to   the   right   side,    as   directed 
above.     The  application  should  continue  five  to  fifteen 
minutes.     If   the   patient    chills    easily,   the   tub   may 
contain  a  sufficient  amount  of  warm  water  to  partially 
immerse  the  body. 

In  cases  of  hypopepsia  and  apepsia  not  accompanied 
by  tenderness  in  the  region  of  the  stomach,  this  douche 
may  be  employed  with  advantage  as  a  means  of  stimu- 
lating the  activity  of  the  stomach  glands.  The  patient 
should  lie  in  such  a  position  that  the  water  will  fall 
upon  a  point  just  below  the  end  of  the  breast  bone. 
The  best  time  for  the  liver  or  stomach  douche  is  just 
before  retiring  at  night,  or  an  hour  or  two  before  din- 
ner. A  heading  compress,  or  wet  girdle  (9),  should  be 
applied  afterward,  and  worn  over  night  or  during  the 
digestion  of  the  meal,  in  obstinate  cases, 


HOME    TREATMENT    OF    DYSPEPSIA. 


301 


21.  The   Hot  and   Cold   Full  Bath.— The 

full  bath  is  prepared  in  the  usual  manner,  with  a  tem- 
perature of  100°  F.  After  lying  immersed  in  water 
for  about  one  minute,  the  patient  rises  to  a  sitting 
posture.  A  quantity  of  cold  water  at  a  temperature  of 
60°  to  70°  F.  is  dashed  about  the  neck  and  shoulders. 
The  patient  then  lies  down  in  the  bath  for  a  minute  or 
two,  the  water  being  warmed  again.  He  then  sits  erect 
while  the  cold  application  is  made  as  before.  The  bath 
may  be  continued  from 
one  to  five  minutes,  con- 
cluding with  a  cold  appli- 
cation and  vigorous  rub- 
bing. 

Another  method  is  to 
administer  a  hot  bath  at 
a  temperature  of  100°  to 
105°  F.  for  five  or  six 
minutes,  or  until  the  skin 
is  reddened.  The  patient 
is  then  taken  from  the 
bath,  and  the  surface 
rubbed  with  a  towel 
wrung  out  of  ice-water,  or 
with  a  piece  of  ice.  The 
executed  very  rapidly.  Lastly  the  patient  should  be 
rubbed  dry  with  a  coarse  towel. 

22.  The  Enema. —This  exceedingly  useful  ap- 
plication of  water  is  best  administered  by  a  syphon  or 
fountain  syringe  (Figs.  29,  30),    A  bulb  syringe  may  be 
employed,  but  there  is  always  danger  of  pumping  air 
into  the  intestiiieSj  and  thus  giving  rise  to  severe  pain» 


FIG.  29.—  SYPHON  SYRINGE. 
cold   rubbing  should    be 


302 


THE    STOMACH. 


The  patient  should  lie  upon  the  back.  The  temperature 
of  the  water  should  be  95°  to  100°  F.  When  the  pur- 
pose is  evacuation  of  the  bowels,  a  small  cold  enema 
is  useful  as  a  means  of  stimulating  the  lower  bowel. 
A  large  hot  enema  is  employed  in  cases  of  catarrh  or 
for  the  relief  of  pain. 

23.  The  Coloclyster.  —  This  is  simply  a  modi- 
fied form  of  the  enema.     The  patient  should  lie  upon 
the  right  side  while  the  water  is  being  introduced,  or 
should  assume  the  knee-chest  position.     In  the  knee- 
chest  position,  the  patient  first  kneels,  then  bends  for- 
ward until  the  head  and  chest  are 
on  a  level  with  the   knees.     The 
thighs  should    be  upright,  so  that 
the  thighs,  trunk,  and  the  surface 
upon  which  the  patient  is   kneel- 
ing shall  form  a  right-angled  tri- 
angle.    The   purpose  of   this   ap- 
plication is  to  render  possible  the 
introduction   of   a  larger  quantity 
of  water   into   the  colon.     Three 
or  even  four  quarts   can   be   thus 
introduced  in  some  cases. 

24.  The  Cold  and  the  Graduated  Enema. 
—The  cold  enema  is  a  powerful  means  of  stimulating 

intestinal  activity.  The  quantity  of  water  used  should 
not  be  greater  than  half  a  pint  in  ordinary  cases. 

The  graduated  enema  consists  of  an  ordinary 
enema  gradually  cooled  from  day  to  day  by  the  addi- 
tion of  half  a  pint  of  cold  water,  the  total  amount  of 
water  employed  being  at  the  same  time  diminished. 
The  amount  of  water  used  each  day  should  be  lessened 


FIG.  30.— FOUNTAIN 
SYRINGE. 


HOME   TREATMENT    OF    DYSPEPSIA. 


303 


sufficiently  so  that  by  the  end  of  ten.  days  or  two  weeks 
the  total  quantity  used  will  not  be  more  than  a  pint, 
and  the  temperature  60°  to  70°  F.  In  a  few  days 
more,  if  proper  diet  and  other  measures  are  employed, 
the  enema  may  be  discontinued. 


Bottle  and  Fountain  SyninDE-  A 


FIG.  31.— WATER  BOTTLE  AND  SYRINGE  COMBINED. 

25.  The  Laxative  Enema. — In  cases  of  ex- 
treme constipation  it  is  sometimes  necessary  to  employ 
a  laxative  enema.  Strong  soapsuds  is  excellent  for 
this  purpose,  and  is  effective  in  most  cases.  It  is 
sometimes  necessary  to  add  common  salt  to  the  water 
20 


304  THE    STOMACH. 

in  the  proportion  of  a  tablespoonful  to  the  quart.  The 
following  mixture  may  also  be  advantageously  em- 
ployed in  very  obstinate  cases  :  Sulphate  of  magnesia, 
one  tablespoonful ;  glycerin,  one  tablespoonful  ;  boil- 
ing water,  two  tablespoonfuls.  The  mixture  should 
be  introduced  as  high  up  in  the  bowel  as  possible,  a 
catheter  being  used  for  the  purpose  if  necessary. 

26.  The  Oil  Enema.  —  Two  or  three  ounces  of 
olive  oil  introduced  into  the  rectum  at  night  serves  as 
a  sufficient  remedy  for   constipation  in  certain   cases. 
The  oil  enema   may  also   be   advantageously  used    in 
cases  in  which  hardened  masses  of  fecal  matter  have 
accumulated  in  the  intestine,  and  cannot  be  removed 
by  the  ordinary  warm-water  enema. 

27.  Oil    Rubbing.  —  Applications    of    oil    are 
always  made  after  certain  kinds  of  baths.     Ordinarily, 
a  tepid  sponge  bath  is  first  given,  after  which  the  oil 
is  systematically  applied  to  the  entire  body  witli  vig- 
orous   rubbing.     Any  excess  of  oil  remaining   should 
be   wiped   away.      Olive   oil,    cocoanut    oil,    or   even 
vaseline  may  be  employed. 

28.  Massage  —  Kneading.  —  Superficial    and 
deep  kneading,  as  illustrated  in  Figs.   1  and  2,  Plate 
VI,   are  among  the  most  useful  procedures   employed 
in  massage.     The  movement  is  that  of  firmly  grasping 
and   then   releasing   the   tissues.     The   purpose   is   to 
knead  and  manipulate  the  skin  and  the  muscles  so  as 
to  stimulate  the  circulation  and  other  vital  activities  in 
these  structures. 

29.  Abdominal  Massage.—  (Fig.  3,  Plate  VI.  i 
The  operator  endeavors  to  seize  the  abdominal  contents 

with    both    hands,    manipulating    them   precisely   as   a 

i  , 


HOME    TREATMENT    OF    DYSPEPSIA.  305 

baker  does  a  mass  of  dough,  the  fingers  of  one  hand 
being  used  in  opposition  to  the  heel  of  the  other  hand, 
and  the  abdominal  contents  kneaded  and  manipulated 
between  the  two  hands.  In  this  procedure  the  heel  of 
one  hand  of  the  manipulator  operates  upon  the  side  of 
the  patient  nearest  him,  while  the  fingers  of  the  other 
hand  operate  upon  the  tissues  of  the  opposite  side. 
This  method  is  only  applicable  to  cases  in  which  the 
abdominal  walls  are  considerably  relaxed.  This,  as 
well  as  most  other  forms  of  abdominal  massage,  requires 
the  services  of  an  assistant,  the  patient  lying  upon  a 
bed  or  couch. 

30.  Massage  of  the  Bowels.  —  (Fig.  4,  Plate 
VI.)  With  the  closed  fists  used  in  alternation,  the 
operator  works  along  the  whole  course  of  the  colon, 
beginning  at  the  lower  end  of  the  cecum,  directing  the 
movements  upward  to  the  lower  border  of  the  ribs  on 
the  right  side,  following  the  oblique  border  of  the 
ribs  to  a  point  midway  between  the  umbilicus  and  the 
sternum,  at  which  the  median  line  is  crossed  ;  then 
down  on  the  opposite  side,  ending  at  a  point  close 
to  the  pubic  bone,  and  just  to  the  left  of  the  median 
line. 

If  the  patient  is  able,  he  should  make  a  practise 
of  kneading  and  percussing  the  abdomen  himself  for 
fifteen  or  twenty  minutes  night  and  morning.  This  is 
a  powerful  stimulant  to  muscular  activity.  Many 
years  ago  a  quack  doctor  in  New  York  City  made  a 
fortune  by  treating  dyspeptics  by  this  method  alone. 
He  put  every  patient  under  an.  oath  of  secrecy,  and 
required  certain  wholesome  restrictions  of  diet,  which 
of  course  aided  in  the  cure, 


306  THE    STOMACH. 

31.  Massage  of  the  Stomach.  —  (Fig.  5,  Plate 
VI.)  With  the  patient  lying  upon  the  back,  the  assist- 
ant stands  upon  the  right  side,  with  his  back  to  the 
patient,  and  executes  the  following  movements  :  Placing 
the  right  hand  upon  the  left  side  of  the  abdomen  oppo- 
site the  umbilicus,  with  the  fingers  extended  and  close 
together,  he  presses  the  ulnar  border  of  the  hand  back- 
ward, at  the  same  time  carrying  it  upward  with  a  vibra- 
tory movement.  Following  along  under  the  ribs  of 
the  left  side,  he  continues  the  movement  upward  to  the 
epigastrium.  At  this  point,  before  releasing  the  tis- 
sues, he  places  the  tips  of  the  fingers  of  the  left  hand 
so  as  to  support  the  tissues  at  the  point  to  which  they 
have  been  lifted  by  the  movement  of  the  right  hand, 
making  firm  pressure  ;  then  withdrawing  the  right 
hand,  he  repeats  the  movement.  This  is  continued  for 
three  or  four  minutes.  If  it  is  desired  to  empty  the 
stomach,  the  strokes  should  be  carried  across  the  epi- 
gastrium, and  along  under  the  lower  border  of  the  ribs 
of  the  right  side.  The  following  movements  are  espe- 
cially useful  in  aiding  digestion  :  — 

Execute  the  movements  just  described,  and  at  the 
same  time  have  the  patient  breathe  deeply.  With 
every  alternate  breath  the  patient  should  execute  what 
the  writer  terms  iiisp't'iiionj  compression,  thus  :  Fill- 
ing the  lungs  completely,  hold  the  breath  for  a  few 
seconds,  and  at  the  same  time  raise  the  head  forward 
as  far  as  possible,  strongly  contracting  the  abdominal 
muscles. 

Gentle  kneading  of  the  abdomen,  especially  its 
upper  portion,  is  an  excellent  means  of  stimulating 
muscular  activity  on  the  part  of  the  stomach,  and  thus 


HOME   TREATMENT    OF    DYSPEPSIA.  307 

preventing  too  long  delay  of  the  food  in  this  part  of 
the  digestive  apparatus.  By  this  means  the  local  cir- 
culation is  stimulated,  and  the  natural  muscular  action 
of  the  bowels  is  both  imitated  and  encouraged.  This 
is  an  excellent  remedy,  and  may  be  employed  to  advan- 
tage each  night  and  morning,  and  for  half  an  hour  or 
more  after  each  meal. 

32.  Replacement  of  the  Viscera.  —  (Fig.  6, 
Plate  VI.)     The  patient  lying  upon  the  back,  with  the 
head  —  not  the  shoulders  —  elevated,  knees  well  drawn 
up,  the  operator  places  his  hands  at  the  lower  portion 
of  the  abdomen  and  presses  inward,  lifting  upward  at 
the  same  time.     The  patient  should  relax  the  abdominal 
muscles  as  perfectly  as  possible,  and  should  take  full, 
deep  respirations.     With  each  expiration  the  operator 
endeavors  to  lift  the  contents  of  the  abdomen  a  little 
higher,  holding  the  hands  firmly  during  the  inspira- 
tion, so  as  not  to  lose  the  ground  gained.     The  patient 
should  take  full,  deep  inspirations,  expanding  the  waist, 
and  lifting  the  chest  well. 

33.  Iiispiratory  Lifting  of  the  Abdominal 
Contents.  —  A  number  of  years  ago  the  author  dis- 
covered a  method  by  which  the  abdominal  organs  may 
be  forcibly  lifted  into  position  by  a  simple  modification 
of  the  breathing   movements.     The  method  is  as  fol- 
lows :   The  patient,   lying  upon  the  back,   after  fully 
emptying  the  lungs,  executes  the  same  movements  as 
in  ordinary  inspiration,  but,  by  closing  the  throat,  pre- 
vents the  admission  of  air  to  the  lungs.     Care  is  taken 
to  raise  the  chest  as  high  as  possible,  and  at  the  same 
time  to  draw  in  the  abdominal  muscles  with  as  much 
force   as   possible.     The  result  is,  that,   no  air  being 


308 


THE  STOMACH. 


admitted  to  the  lungs,  the  stomach,  bowels,  and  other 
viscera  are  sucked  up  into  the  chest  in  a  very  forcible 
manner.  By  grasping  the  lower  abdomen  with  the 
hands,  and  lifting  upward  at  the  same  time  this  move- 
ment is  executed,  the  effect  upon  prolapsed  organs  may 
be  greatly  increased.  Fig.  7,  Plate  VI.  shows  very 
clearly  how  this  movement  is  effected. 

34.  Hacking.  —  This  consists  in  stroking  the 
part  with  the  edge  of  the  hand,  the  fingers  being 
separated,  as  shown  in  Fig.  8,  Plate  VI. 

35.  Beating. -- This    pro- 
cedure  of    massage    consists    in 
striking  the  body  with  the   half- 
closed  fist,  as  shown   in  Fig.   9, 
Plate  VI. 

36.  General  Massage.  — 
General   massage  consists  in  the 
rubbing  and  manipulation  of  the 
whole    body.       The    movements 
are  chiefly  those  described  as  fric- 

FIG.  32.- ARM  FLEXION.    tion  and  kneading  (28).     These 

movements  are  applied  to  the  limbs  and  back.  Ab- 
dominal massage  (29)  and  massage  of  the  stomach  and 
bowels  (30,  31)  are  employed  for  the  abdominal  re- 
gion ;  hacking  and  beating  (34,  35)  for  the  spine 
(Figs.  8  and  9,  Plate  VI),  especially  the  lower  part  of 
it,  the  fleshy  portion  of  the  thighs,  over  the  liver, 
and  the  large  nerve  trunks. 

Joint  movements,  or  flexion  of  the  arms  and  legs, 
with  resistance,  are  employed  in  general  massage. 
The  patient  is  made  to  draw  the  limb  up  while  the 
assistant  offers  slight  resistance  to  his  doing  so.  The 


HOME  TREATMENT  OF  DYSPEPSIA. 


309 


patient  then  extends  the  limb  while  the  assistant  makes 
resistance  in  like  manner.  The  movement  is  repeated 
several  times,  the  number  of  times  and  the  amount 
of  resistance  offered  being  regulated  according  to  the 
strength  of  the  patient.  Figs.  32  and  33  illustrate  arm 
flexion  and  extension. 

An  expert  is  required  for  the  administration  of 
massage  in  a  thoroughly  skilled  manner.  In  another 
work*  the  author  has  given  a  full  description  of  the 
various  procedures  and  manipulations  in  massage. 

37.  Exercise.  —  This  is 
of  first  importance  as  a  general 
renovator  of  the  tissues.      The 
secretion  of  gastric  juice  is,  un- 
der ordinary  circumstances,  pro- 
portionate  to    the    amount    of 
nourishment  which  the  system 
is  prepared  to  assimilate.     Ex- 
ercise creates  a  demand   for 
food,  and  so  stimulates  both  as- 
similation and   secretion.     The* 
best  forms  of  exercise  are  those 
which  will  secure  the  most  uni-    FlG'  *•-***  EXTENSION- 
form  activity  of   the  several   parts   of    the    muscular 
system.    Biding,  walking,  rowing,  and  especially  horse- . 
back  riding  are  to  be  recommended  as  excellent.     Gym- 
nastic exercises  and  the  judicious  use  of  the  ' '  health 
lift  'rare  also  good  ;  and  for  persons  who,  for  lack  of 
time  or  for  any  other  cause,  cannot  adopt   the    other 
methods,    these    may    be    considered    as   almost  indis- 


*  "  The  Art  of  Massage,"  Modern   Medicine  Publishing  Co.,  Battle 
"  Creek,  Mich. 


310  THE    STOMACH. 

pensable.  Such  exercises  as  running,  jumping,  base- 
ball playing,  walking  matches,  and  other  violent  exer- 
cises cannot  be  recommended.  Trapeze  exercise  must 
also  be  discouraged  on  the  same  grounds.  Agricultural 
labor,  especially  the  raising  of  small  fruits  and  the  cul- 
tivation of  flowers,  cannot  be  too  highly  recommended 
as  forms  of  exercise  for  dyspeptic  patients.  For  that 
large  class  of  sallow-faced,  weak- backed  young  ladies 
who  have  been  made  dyspeptics  by  idleness  and  too 
much  coddling  by  fond  mothers,  the  varied  exerei-cs 
of  domestic  labor  are  a  most  admirable  panacea.  And 
for  the  gaunt,  hollow-cheeked,  sunken-eyed  young  man, 
whose  principal  occupation  is  cultivating  a  moustache, 
smoking  cigarettes,  and  swinging  a  slender  cane,  a  lit- 
tle wholesome  experience  in  earning  a  subsistence  by 
the  sweat  of  his  brow,  instead  of  depending  upon 
wealthy  relatives,  will  prove  a  specific  for  the  "soft- 
ening" which  begins  in  the  brain,  and  extends  to 
every  part  of  the  system. 

Exercise  before  breakfast,  while  excellent  for  some, 
may  be  very  harmful  for  others.  Persons  who  com- 
plain of  a  feeling  of  "goneness,"  "faintness, "  "sink- 
ing," and  allied  pains  when  the  stomach  is  empty, 
and  especially  in  the  morning,  must  avoid  exercise  to 
any  considerable  extent  before  eating.  Disregard  of 
this  rule  often  occasions  loss  of  appetite  and  weakening 
of  the  digestion.  Persons  who  are  very  weak  must 
also  avoid  exercise  before  eating  in  the  morning. 

As  before  remarked,  only  gentle  exercise  can  be 
taken  soon  after  eating,  or  immediately  before,  without 
injury.  Persons  who  feel  a  constant  '<  sinking"  or 
weakness  in  the  stomach  and  bowels,  will  derive  benefit. 


HOME   TREATMENT    OF    DYSPEPSIA.  311 

from  wearing  about  the  body  a  broad  band  of  flannel. 
In  many  of  these  cases  the  Natural  Abdominal  Sup- 
porter will  be  found  of  great  advantage.  It  is  in  these 
cases  especially  that  complaint  is  made  that  walking 
produces  coldness  in  the  extremities,  instead  of  serving 
to  warm  them. 

One  of  the  most  marked  effects  of  exercise  upon 
digestion  is  to  increase  the  activity  of  the  gastric 
glands,  and  thus  promote  the  secretion  of  the  gastric 
juice.  This  has  been  clearly  shown  by  recent  experi- 
ments. It  is  hence  apparent  that  in  hyperpepsia  little 
or  no  exercise  should  be  taken  immediately  after  eat- 
ing, whereas  in  hypopepsia  moderate  exercise  after 
eating  may  prove  beneficial  by  increasing  the  activity 
of  the  gastric  glands. 

Exercises  to  Develop  the  Abdominal  Muscles. —  De- 
velopment of  the  abdominal  muscles  is  one  of  the  most 
important  of  all  curative  measures  in  chronic  indiges- 
tion, since  its  most  obstinate  forms  are  due  to  prolapse 
of  the  stomach,  and  those  forms  of  constipation  least 
benefited  by  a  regulation  of  the  diet  or  other  curative 
means  are  usually  the  result  of  prolapse  or  dilatation 
of  the  colon.  Development  of  the  abdominal  muscles 
benefits  cases  of  this  kind  by  holding  the  prolapsed 
organs  in  place,  and  also  by  increasing  the  pressure 
within  the  abdominal  cavity,  as  well  as  the  expulsive 
power.  The  following  are  among  the  most  excellent 
exercises  for  developing  the  abdominal  muscles  :  — 

(1)  Lying  upon  the  back,  raise  the  head  forward  as 
far  as  possible  without  the  use  of  the  arms.  Repeat 
every  five  seconds,  breathing  in  as  the  head  goes  back, 
and  breathing  out  as  the  head  is  raised  forward. 


312  THE   STOMACH. 

(2)  Raise  the  right  leg  as  high  as  possible,   and 
return  to  position.     Repeat  with  the  left  leg,  then  with 
both  legs.     Empty  the  lungs  as  the  leg  is  raised,  filling 
the  lungs  as  the  leg  is  lowered  to  position.     Repeat 
each  exercise  three  to  twenty  times. 

(3)  Combine  exercises  1  and  2,  following  the  same 
instructions  in  regard  to  breathing  (Fig.  10,  Plate  VI). 

(•i)  Lying  upon  the  back,  with  the  legs  extended, 
rise  to  the  sitting  position  without  using  the  arms. 
Slowly  return  to  the  horizontal  position  ;  repeat  three 
to  twenty  times.  Exhale  while  rising  to  the  sitting 


^////////mmm\\w$m^ 

FIQ.  34.— EXERCISE  TO  STRENGTHEN  TRUNK  MUSCLES. 

position  ;   take  one   full  breath  after  each  movement. 

(5)  Repeat  exercise  4,  with  the  hands  placed  at  the 
top  of  the  head,  and  the  elbows  extended  sideways  and 
in  line  with  the  body. 

(6)  Lying  upon  the  face,  place  the  trunk,  elbows, 
and  toes  in  such  a  position  that  the  whole  body  will  be 
suspended  upon  the  elbows  and  toes.    Lower  the  center 
of  the  body  until  it  rests  upon  the  supporting  surface  ; 
then  raise  to  a  horizontal  position,  repeating  three  to 
twenty  times  (Fig.  34). 

(7)  Lying  upon  the  back  with  the  knees  drawn  up, 
separate  the  knees  as  widely  as  possible,   then  bring 
them  together  again.     The  assistant  should  meanwhile 
make   resistance  to  each  movement   by  pressing    first 


SOME    TREATMENT    OF    DYSPEPSIA.  313 

on  the  outer,  then  the  inner  surface  of  the  knees  (Fig. 
11,  Plate  VI.) 

(8)  An  excellent  exercise  for  strengthening  the 
abdominal  muscles  is  the  following :  Standing  with 
the  feet  separated  as  in  Fig.  39  (page  319),  and  the 
hands  placed  upon  the  hips,  the  patient  bends  gently 
forward  until  a  strain  is  felt  upon  the  abdominal  mus- 
cles, then  rises  to  position,  repeating  the  exercise  a 
number  of  times. 

38.  Breathing  Exercises.  —  The  following  ex- 
ercises in  breathing  will  be  feund  very  helpful  to  diges- 
tion. Before  engaging  in  them  it  is  well  to  take  a 
little  vigorous  general  exercise,  as  jumping  up  and 
down  or  a  short  run,  which  will  create  a  thirst  for  air. 

(1)  Breathe  in  the  ordinary  manner  for  one  minute, 
taking  care  that  the  greatest  expansion  is  at  the  sides 
of  the  waist. 

(2)  Fill   the   lungs  as  full   as   possible,   breathing 
slowly  in  and  out,  forcing  the  sides  of  the  chest  out  as 
far  as  possible.     Be  careful  not  to  confine  the  breath- 
ing to  the  upper  part  of  the  chest.     Occupy  equal  time 
in  breathing  in  and  out, —  about  five  seconds  each  for 
inspiration  and  expiration  (Fig.  12,  Plate  VI). 

(3)  Take  a  deep  breath  occupying  about  two  sec- 
onds, and  breathe  out  in  puffs,  occupying  about  five 
or  six  seconds  in  expiration. 

(4)  Take  a  quick,   deep  inspiration,  expanding  the 
lungs  as  fully  as  possible,  and  follow  with  a  prolonged 
expiration,  sounding  the  syllable  "ah." 

(5)  Standing  or  sitting,   repeat  each  of  the  above 
exercises,  at  the  same  time  raising  the  arms  from  the 
sides  to  a  horizontal  position  while  inhaling,  and  allow- 


314 


THE    STOMACH. 


FIG.  35.— LYING,  KNEE  BENDING. 


ing   them   to   return   to   position  by    the    sides    while 
exhaling. 

(6)  Repeat  exercises  1  to  4,  raising  the  arms  from 
the  sides  to  a  vertical  position,  reaching  overhead  as 

high  as  possible  at  the 
end  of  inspiration,  and 
allowing  the  arms  to  re- 
turn to  the  sides  during 
expiration. 

(7)  Chest  Liftinfj. — 
In  Fig.  36  is  shown  a 
most  excellent  exercise, 
which,  however,  r  e- 
quires  the  aid  of  an 
assistant.  The  patient 
sits  in  a  chair  while 
the  assistant  stands 
behind  him.  The  assistant  bends  forward,  grasps  the 
arms  a  few  inches  below  the  shoulders,  and  lifts  them 
upward  and  backward,  the  patient  drawing  in  his 
breath  at  the  same  time.  The  arms  should  be  drawn 
upward  far  enough  to  produce  a  decided  strain  upon 
the  chest  walls.  After  being  held  in  position  a  few 
seconds,  the  arms  are  returned  to  the  sides.  The 
movements  are  repeated  ten  to  twelve  times  a 
minute,  the  patient  taking  a  deep  breath  after  each 
movement.  The  clothing  should  be  loose  enough  to 
allow  the  organs  of  respiration  free  play. 

Manual  Swedish  Movements. — Among  the 
most  important  of  all  forms  of  exercise  useful  in  indi- 
gestion, must  be  mentioned  Swedish  medical  gymnas- 
tics, or  what  are  ordinarily  termed  "manual  Swedish 
movements."  Full  directions  for  the  employment  of 


HOME  TREATMENT  OF  DYSPEPSIA. 


315 


manual  Swedish  movements  in  disease  will  be  found 
in  a  most  excellent  work  no  "Swedish  Movements, 
or  Medical  Gymnastics, ' '  by  Professor  T.  J.  Hartelius, 
M.  D.,  director  of  the  Central  Gymnastic  Institute  of 
Stockholm,  Sweden,  recently  translated  by  Dr.  A.  B. 
Olsen,  and  edited  by  the  writer ;  published  by  the 
Modern  Medicine  Publishing  Co.,  Battle  Creek,  Mich. 

The  following  groups  of  movements  have  been 
found  especially  valuable  in  the  treatment  of  cases  of 
chronic  indigestion  :  — 

39.  For  General  Debility  and  Anemia.  - 

A. 

Repeat  each  of  the  following  movements  four  to 
eight  times  :  - 

1.  Lying,  full  breath- 
ing (38)  (Fig.    12,  Plate 
VI). 

2.  Lying,     knees 
drawn   up,    knees    separa- 
ting and  closing  with  re- 
sistance   (Fig.    11,    Plate 
YI)  (37  [T]). 

3.  Replacement    of 
the    abdominal    organs 
(Fig.  G,  Plate  YI). 

4.  Alternate    head 
raising  and  leg  raising  for- 
ward (Fig.  10,  Plate  YI). 

5.  Sitting,     arm 
flexion,  extension  and  rol- 
ling  (Figs.   32,  33)   (36). 

6.  Lying,   inspiratory  lifting  (Fig.  7,   Plate  YI), 


316 


THE    STOMACH. 


B. 


Repeat  each  of  the  following   movements  four  to 
eight  times  :  — 

1.  Inspiratory  lifting  (Fig.  7,  Plate  YI). 

2.  Lying,  knee  bending  and  stretching  (Fig.  35). 


FIG.  37.— SACRUM  BEATING. 

3.  Hacking  over  liver,  stomach,  and  spleen  (Fig.  8, 
Plate  VI). 

4.  Sitting,  arms  extended  sideways,  arms  rolling. 

5.  Lying,  raise  trunk  to  sitting  position  (37  [4]). 

6.  Lying,  knee  bending  and  stretching. 

7.  Replacement   of    abdominal    organs .  (Fig.    6, 
Plate  YI). 

8.  Sitting,  chest  lifting  (Fig.  36)  (38  [7]), 


HOME   TREATMENT    OF    DYSPEPSIA.  317 

£0.  For  Dilatation  of  the  Stomach.  —  The 

following  movements  may  also  be  employed  for  dilata- 
tion of  the  stomach  and  prolapse  of  the  stomach  and 
bowels,  which  are  usually  present  in  cases  of  nervous 
headache  :  — 

Repeat  each  of  the  following  movements  four  to 
eight  times  :  — 

1.  Chest  lifting  (Fig.  36). 

2.  Lying,  knees  bent,  knees  separating  and  closing 
(Fig.  11,  Plate  VI)  (37  [7]). 

3.  Sitting,  arm  raising,  full  breathing  (38  [5]). 

4.  Standing,    hands    upon    the    hips,     backward 
bending. 

5.  Lying,  knee  bending  and  stretching  (Fig.  35). 

6.  Lying,  leg  and  head  raising  in  alternation  (Fig. 
10,  Plate  VI)  (37  [1,  2,  3]). 

7.  Sitting,  neck  twisting  and  bending. 

8.  Inspiratory  lifting  (Fig.  7,  Plate  YI). 

9.  Reach-support-standing,  sacrum  beating  (Fig.  9, 
Plate  YI  ;  Fig.  37). 

10.  Sitting,  gentle  hacking  of  head  (Fig.  8,  Plate 
YI),  stroking  head  and  neck  downward. 

41.  For  Prolapse  of  Stomach,  Bowels, 
Colon,  Kidneys,  and  Other  Abdominal  Or. 
gans.— 

Repeat  each  of  the  following  movements  four  to 
eight  times  :  — 

1.  Chest  lifting  (Fig.  36). 

2.  Replacement    of    abdominal    organs    (Fig.   6, 
Plate  YI). 

3.  Lying  on  back,  leg  and  head  raising  (Fig.  10, 
Plate  YI)  (37  p,  2,  3]). 


318 


THE    STOMACH. 


4.  Inspiratory  lifting  (Fig.  7,  Plate  VI). 

5.  Lying,    knees    bent,     kneading   of    abdominal 
muscles. 

6.  Sitting,  knees  separated,   trunk   twisting  right 
and  left. 

7.  Lying,     raise    to     sitting    position    (Fig.    .">   ) 
(37  [4])! 

8.  Sitting,  bent  forward,,  raise  backward  with  pres- 
sure upon  the  loins. 

9.  Repeat  exercise  2  with  inspiratory  lifting. 
10.  Repeat  exercise  3. 

4>2.  For  Dyspepsia  with  Dilatation  of  the 
Stomach.  - 

Repeat  each  of  the  fol- 
lowing movements  four  !<• 
eight  times  :  — 

1.  Chest  lifting  (Fig. 
36). 

2.  Reach-s  u  p  p  o  r  t- 
standing,     spine     hacking 
and  sacrum  beating  (Figs. 

8,  9,  Plate  VI;  Fig.  37). 
FIG.  38.— EXERCISE  FOR  AB-  0     T     .         , 

DOMINAI,  MUSCLES.  3.  Lying,  knees  bent, 

kneading   the    stomach 
(Fig.  5,  Plate  VI ;  Fig.  35). 

4.  Lying,    leg  and  head    raising  (Fig.    10,   Plate 
VI)  (37  [1,  2,  3]). 

5.  Arm  raising,  full  breathing  (38  [5]). 

fi.   Lying,  knees  bent,  pressing  under  right  and  left 
ribs  with  vibratory  movements. 

7.  Sitting,  trunk  twisting  to  right  and  left. 

8,  Repeat  exercise  3, 


HOME    TREATMENT    OF    DYSPEPSIA. 


319 


9.   Lying,  knees  bent,  knees  separating  and  closing 
with  resistance  (Fig.  11,  Plate  YI)  (37  [7]). 

10.  Repeat  exercise  6. 

11.  Standing,  forward  bent,   sacrum  beating  (Fig. 
37). 

43.  For  Constipation.— 

Repeat  each  of  the 
following  movements  four 
to  eight  times  :  — 

1.  Standing,     feet 
separated,  sideways  bend- 
ing to  right  and  left  (Fig. 
39). 

2.  Chest  lifting  (Fig. 
36)  (38  [7]). 

3.  Sitting,      twisting 
to  right  and   left. 

4.  Inspiratory   lifting 
(Fig.  7,  Plate  YI). 

5.  Lying,  knees  bent,  kneading  of  the  colon  (Fig. 
4,  Plate  YI). 

6.  Head  and  leg  forward  raising  (Fig.  10,   Plate 
YI)  (37  [1,  2,  3]). 

7.  Sitting,  feet  separated,   describe  a  large  circle 
with  the  head  and  shoulders,  holding  the  trunk  straight 
and  the  hips  stationary. 

8.  Repeat  exercise  4. 

9.  Reach-support-standing,   sacrum    beating  (Fig. 
37). 

10.  Sitting,  arms  stretched  above  head,  bend  arms 
with  resistance,  back  supported  by  the  knee  of  the 
attendant. 

21 


FIG.  39.—  STANDING,  SIDE- 
WAYS BENDING. 


320 


THE    STOMACH. 


44.  The  Dry  Abdominal  Bandage. —  A  dry 

flannel  bandage  worn  about  the  abdomen  is  often  of 
great  value  in  cases  of  indigestion.  The  whole  abdo- 
men, from  the  lower  end  of  the  sternum  to  the  pubes, 
should  be  covered  by  the  bandage,  which  should  fit  the 
skin  snugly.  It  should  always  be  worn  during  the  day- 
time by  persons  who  wear  the  wet  girdle  at  night. 

45.  The   Abdominal    Supporter. — The   ab- 
dominal supporter  (Fig.  40)  consists,  first,  of  two  hard 
rubber  pieces  connected  by  an  elastic  webbing,  which 

rest  against  the  lower  abdo- 
men, being  carefully  shaped 
so  as  to  make  a  uniform 
pressure;  and  second,  a  set 
of  steel  springs  attached  to  a 
back  piece,  and  so  adjusted 
as  to  make  pressure  upon 
the  hard-  rubber  plates  simul- 
taneously backward  and  up- 
ward. The  action  of  the 
supporter  is  almost  a  perfect 
imitation  of  the  hands  in 
lifting  the  prolapsed  ab- 
dominal contents.  After  trying  every  form  of  sup- 
porter offered  in  the  market,  I  have  found  the  Natural 
Abdominal  Supporter  more  satisfactory  than  any  other, 
and  have  employed  it  in  a  very  large  number  of  cases. 
It  is  manufactured  and  sold  by  the  Modern  Medicine 
Company,  Battle  Creek,  Mich. 

46.  Lavage. — The  accompanying  cut  (Fig.  41) 
shows   an   approved   form   of   stomach-tube,  which  is 
used  in  obtaining  a  test  meal  for  the  examination  of  the 


FIG.  40.—  NATURAL  AB- 
DOMINAL SUPPORTER. 


HOME    TREATMENT    OF    DYSPEPSIA..  321 

stomach  fluid,  and  for  washing  out  the  stomach  when 
necessary. 

The  most  suitable  time  for  washing  the  stomach  is 
just  before  retiring  at  night,  or  five  or  six  hours  after 
the  last  meal.  The  operation  is  by  no  means  so  diffi- 
cult or  distressing  as  it  might  appear.  The  tube  em- 
ployed is  of  very  soft,  flexible  rubber.  It  is  not  forced 
down  into  the  stomach  after  the  fashion  of  the  old 
stomach-pump,  but  is  simply  swallowed  as  one  would 
swallow  a  portion  of  food  or  a  capsule.  One  end  of 
the  tube  being  introduced 
into  the  mouth  and  passed 
well  back  into  the  throat,  the 
patient  makes  movements 
of  swallowing  whereby  the 
tube  is  readily  carried  into 
the  stomach.  Water  of 
about  the  temperature  of  the 

body    is    then    poured    in, 

J  FIG.  41.— STOMACH-TUBE. 

either  with  or  without  the  ad- 
dition of  common  salt  and  soda  in  the  proportion  of  a 
teaspoonful  of  each  to  a  quart  of  water.  A  powder 
consisting  of  three  parts  of  bicarbonate  of  soda,  one 
part  of  sodium  sulphid,  and  one  part  of  chlorid  of 
sodium,  may  be  advantageously  used  in  cleansing  the 
stomach,  one  teaspoonful  of  this  powder  being  added 
to  each  pint  of  water  used  in  cleansing  the  stomach. 
After  a  pint  or  so  of  water  has  been  poured  into  the 
stomach,  the  outer  end  of  the  tube  is  lowered,  and  by 
coughing  or  similar  movements  the  contents  of  the 
stomach  are  forced  through  the  tube  into  some  proper 
receptacle.  Repeat  until  the  water  is  clear. 


322  THE    STOMACH. 

Hot  and  Cold  Lavage  of  the  Stomach. —  The  pur- 
pose of  hot  and  cold  lavage  of  the  stomach  is  to  stimu- 
late the  secretion  of  pepsin  and  hydrochloric  acid  in 
cases  of  hypopepsia  and  apepsia.  The  general  method 
is  the  same  as  that  for  lavage.  The  temperature  of  the 
fluid  used  may  vary  from  70°  to  120°  F.,  and  the 
quantity  from  half  a  pint  to  a  pint.  Ordinarily,  at  the 
beginning,  the  extremes  of  temperature  should  not  be 
more  than  20°  F.,  or  85°  to  105°  F.  Alternate  hot 
and  cold  applications  are  a  powerful  means  of  stimulat- 
ing vital  activity,  and  the  method  is  as  serviceable 
when  applied  to  mucous  membranes  as  to  the  skin. 

47.  Charcoal. —  Charcoal  is  valuable  by  reason  of 
its  remarkable  absorbent  qualities,  whereby  it  takes  up 
the  poisonous  substances  produced  in  the  stomach,  thus 
preventing  their  absorption.  It  also  exercises  a  very 
remarkable  influence  in  preventing  certain  forms  of 
fermentation  in  the  stomach.  It  should  be  impalpably 
fine,  so  that  it  will  not  produce  irritation  of  the  mucous 
membrane,  and  should  be  freshly  prepared.  The  author 
has  succeeded  in  preparing,  and  has  for  many  years 
employed,  a  special  form  of  charcoal  made  from  cere- 
als, which  he  has  found  to  be  very  much  superior 
to  the  willow  charcoal  obtainable  at  the  drug-stores. 
Charcoal  must  be  taken  in  large  doses  (a  heaping  tea- 
spoonful  at  least)  to  be  of  any  service.  It  is  best  taken 
by  mixing  with  a  little  water.  At  first  use  just  enough 
water  to  moisten,  then  add  more. 

4-8.  Charcoal  Tablets. —  The  Modern  Medicine 
Company,  Battle  Creek,  Mich.,  U.  S.  A.,  have  suc- 
ceeded in  preparing  charcoal  in  the  form  of  tablets, 
which  are  more  convenient  for  use  than  the  pulverized 


HOME  TREATMENT    OF    DYSPEPSIA.  323 

charcoal,  as  they  can  be  handled  readily,  and  taken  witli 
out  water  and  without  inconvenience,  besides  retaining 
their  active  properties  indefinitely. 

4-9.  Antiseptic  Charcoal  Tablets.  —  These 
tablets  are  also  prepared  by  the  Modern  Medicine 
Company,  and  are  found  to  be  the  most  effective 
means  of  preventing  fermentation  and  decomposition 
in  the  stomach.  They  are  especially  valuable  in  acid 
and  bilious  dyspepsia,  and  in  cases  in  which  the  tongue 
is  heavily  coated. 

50.  Lactic  Acid. —  Lactic  acid,  in  the  proportion 
of  one  ounce  of  the  acid  to  three  of  water,  is  a  useful 
remedy  in  cases  of  hypopepsia  without  fermentation. 
The  dose  should  be  one  teaspoonful  in  water  immedi- 
ately after  each  meal. 

51.  Hydrochloric  Acid.— Hydrochloric  acid,  in 
the  proportion  of  one  dram  of  the  acid  to  three  ounces 
of  water,  is  useful  in  cases  of  hypopepsia  and  apepsia, 
but  should  not  be  used  habitually.     Two  teaspoonfuls 
in  water,   half  an  hour  after  each  meal,   constitutes  a 
dose  ;  a  second  dose  may  be  taken  half  an  hour  later. 

52.  Laxatives.  —  Such  fruits  as  tamarinds,  figs, 
manna,  and  prunes,  with  a  tablespoonful  of  bran  mixed 
with  boiling  water,  are  all  food  laxatives  of  value  in 
many  cases.     Antiseptic  charcoal  tablets  (49),  three  or 
four   after   each   meal,    also   have    an   excellent   laxa- 
tive effect.     The  advantage  of  these  tablets  is  that  their 
continued  use  does  not  destroy  their  efficiency,  as  is  the 
case  with  most  laxatives. 

53.  Cascara   Sagrada. — The  fluid   extract  of 
cascara   sagrada   is   one   of   the   most  valuable  of   all 
drugs  for  temporary  use  as  a  laxative  in  cases  of  inac- 


324  THE    STOMACH. 

tivity  of  the  bowels.  The  dose  is  fifteen  to  thirty 
drops  of  the  fluid  extract  taken  at  night  in  a  little 
water  and  before  breakfast,  for  a  few  days.  It  should, 
however,  be  used  only  for  a  short  time,  as  it  usually 
loses  its  effect  when  long  continued. 

54.  Aqua  Salina. — This  is   composed  of   sul- 
phate of  soda,  one  and  one  half  ounces  ;  sulphate  of 
magnesia,  one  half  dram  ;  sodium  chlorid,  one  fourth 
dram  ;  water,  one  pint.     One  fourth  to  one  half  a  glass- 
ful, diluted  with  cold   water,  should  be   taken  before 
breakfast.     This  is  an  excellent  substitute  for  the  best 
of  the  laxative  mineral  waters,  but  should  be  used  only 
in  case  of  emergency, when  the  enema  cannot  be  em- 
ployed, and  should  not  be' long  continued. 

55.  Seltzer.  —  This  is  composed  of  sulphate  of 
magnesia,  one  ounce  ;  tartaric  acid,  three  and  one  half 
ounces  ;  bicarbonate  of  soda,  four  ounces.     The  dose 
is  two  to  four  heaping  teaspoonfuls,  in  water,  before 
breakfast.     Use  same  as  54. 

56.  Sulphur.  —  Sulphur  is  an  old-fashioned  but 
useful  remedy  as  a  laxative  and  intestinal  antiseptic. 
It  should  be  taken  in  ten-grain  doses  three  times  a  day, 
or  in  doses  of  one  half  a  dram  at  bedtime.     It  may  be 
mixed  with  a  little  molasses  or  brown  sugar. 

57.  Antiseptic    Dentifrice.  --  This    excellent 
preparation  for  cleansing  the  teeth  is  based  upon  the 
extract  of  the  bark  of  the  famous  soap-tree  of  South 
America  and  aromatic  antiseptics.     It  may  be  obtained 
of  the  Modern  Medicine  Company,  Battle  Creek,  Mich. 

58.  Cinnamon  Solution. —  Add  two  teaspoon- 
fuls of  oil  of  cinnamon  to  a  pint  of  water  ;  shake  thor- 
oughly.    This  is  to  be  used  as  a  lotion  for  rinsing  and 
washing  the  mouth. 


HOME    TREATMENT    OF    DYSPEPSIA. 


325 


59.  The  Perfection  Vaporizer. — This  is  an 
excellent   instrument  for   the  vaporization  and  nebu- 
lization  of  medicated 

solutions  for  use  in 
the  treatment  of  af- 
fections of  the  throat 
and  nose  (Fig.  42). 
It  is  for  sale  by  the 
Modern  Medicine 
Company. 

60.  Benzoin 
Solution.  —  Gum 
benzoin  and  all  other 

balsams  and  essential 

FIG.  42.  —  PERFECTION  VAPORIZER. 

oils    are    antiseptics, 

and,  used  by  means  of  the  Perfection  Vaporizer,  are  of 
great  value  in  the  treatment  of  diseases  of  the  nose 
and  throat.  The  following  solution,  in  which  benzoin 
is  one  of  the  principal  ingredients,  has  been  found 
especially  valuable  :  — 

3     Compound  Tr.  Benzoin. . .    drms.  6 
Oil    Cinnamon,    Oil    Win- 
tergreen,  Oil  Eucalyptus, 

Menthol  Crystals aa.  drm.  1 

Alcohol drms.   15 

61.  Guaiac  Solution.— 

3  Menthol   Crystals, 
Oil  Eucalyptus,   Tr. 

Guaiac aa.drm.  1 

Alcohol drms.  9 

62.  Subcarbon- 
ate  of  Bismuth.— 

Subcarbonate  and  sub- 
FIG.  43.— VAPORIZER  IN  USE.        nitrate  of  bismuth  are 


326  THE    STOMACH. 

two  very  useful  drugs,  which  may  be  frequently  used 
to  advantage  in  cases  of  indigestion  accompanied  by 
great  irritation  of  the  mucous  membrane,  and  are  in- 
valuable in  ulcer  of  the  stomach  and  in  hyperpepsia. 
The  dose  is  fifteen  to  thirty  grains  before  each  meal. 
When  lavage  of  the  stomach  gives  pain,  it  should  be 
followed  by  a  dose  of  twenty  to  thirty  grains  of  subni- 
trate  or  subcarbonate  of  bismuth. 

63.  Subgallate  of   Bismuth.  —  Subgallate   of 
bismuth  is  an  excellent  intestinal  antiseptic,  five  to  ten 
grains  to  be  taken  before  each  meal.     It  is  especially 
valuable  in  cases  in  which  there  is  a  tendency  to  loose- 
ness of   the   bowels,   as  it  is   somewhat  astringent  in 
its  nature.     It  has  a  tendency  to  produce  constipation 
when  its  use  is  long  continued.     It  is,  on  this  account, 
inferior  to  antiseptic  charcoal  tablets  (4-9)  as  an  intes- 
tinal antiseptic,  but  is  especially  valuable  in  cases  in 
which  an  intestinal  antiseptic  is  required  in  connection 
with  an  irritable  condition  of  the  stomach  and  in  cases 
of  intestinarcatarrh. 

64.  Bicarbonate  of  Soda. —  This  much-abused 
drug   may  be  usefully  employed  in  hyperpepsia  and 
ulcer  of  the  stomach,  in  which  it  should  be  taken  in 
twenty-  to  thirty-grain  doses,  just  before  eating,  in  very 
severe  cases,  or  two  or  three  hours  after  eating  in  cases 
of  less  severity. 

65.  Local  Applications  of  Faradic   Elec- 
tricity.—  Care  should  be  taken  that  the  sponges  are 
moist,   the   conducting  cord  in  good   repair,    and  the 
battery  in  good  order.     Strong  currents  are  generally 
best  for  relieving  pain.     When  it  is  desired  to  exercise 
the  muscles,  the  sponges  should  be  applied  near  the 


HOME    TREATMENT    OF    DYSPEPSIA.  327 

edges  of  the  muscle,  and  the  current  should  be  rapidly 
interrupted  by  removing  the  sponge  and  replacing  it, 
so  as  to  produce  repeated  muscular  contractions.  The 
application  of  electricity  to  the  rectum  is  a  most  excel- 
lent means  of  relieving  constipation.  A  special  elec- 
trode is  required  for  the  rectum,  a  large,  flat  sponge 
being  placed  over  the  abdomen.  In  the  absence  of  a 
special  electrode,  a  small  sponge  may  be  applied  to 
the  anus. 

66.  General  Applications  of  Faradic  Elec- 
tricity.—  As  a  general  tonic,  the  current  is  applied 
in  the  following  manner  :  A  large,  flat  sponge  is  placed 
at  the  feet  or  connected  with  the  feet  by  means  of  a 
foot  bath,  one  sponge   being   dropped   into   the   bath 
while  the  other  sponge  is  passed  over  the  whole  surface 
of  the  body, —  first  the  spine,  then  the  arms  and  legs, 
then   the   trunk,  —  the    strength  of   the  current    being 
sufficient  to  create  a  slight   tingling  sensation    as   the 
sponge  is  brushed  over  the  surface,  without  producing 
muscular  contraction. 

For  muscular  effects,  the  following  mode  of  appli- 
cation is  employed  :  .Two  sponges,  held  a  few  inches 
apart,  are  applied  to  the  muscles  of  the  arms,  legs,  and 
trunk  in  such  a  way  as  to  cause  strong  contraction  of 
the  muscles.  By  frequent  interruption  of  the  current 
by  the  removal  and  replacement  of  one  of  the  sponges, 
repeated  contractions  are  produced.  Thus  all  the  mus- 
cles of  the  body  may  be  exercised. 

67.  The   High    Tension    Sinusoidal    Cur. 
rent.  —  This    current   is    obtained    from  a   specially 
constructed   electrical  apparatus  (see  Fig.  44),   and  is 
particularly  efficacious  in  relieving  pain,  often  succeed- 


328  THE  STOMACH.  - 

ing  when  other  means  fail.     The  current  is  applied  the 
same  as  the  faradic  current  (65,  66). 

68.  The  Low  Tension  Sinusoidal  Cur- 
rent.  —  This  current  is  obtained  from  the  same  appa- 
ratus as  the  preceding,  but  by  a  different  adjustment  of 
the  machine.  It  is  especially  useful  for  exercise  of  the 
muscles,  especially  those  of  the  trunk  and  abdomen. 
It  is  very  valuable  as  a  means  of  relieving  chronic  con- 


FIG.  44.    SINUSOIDAL  ELECTRICAL  APPARATUS. 

stipation.  "When  used  for  this  purpose,  a  metal  elec- 
trode is  placed  in  the  rectum,  and  a  large  sponge  over 
the  abdomen.  The  current  should  be  of  sufficient 
strength  to  cause  vigorous  contraction  of  the  abdominal 
muscles.  The  abdominal  muscles  are  thus  strengthened 
and  the  nerves  of  the  rectum  stimulated. 

69.  Galvanization  of  the  Spine  and  Ab. 
domen.  — A  galvanic  battery  of  thirty  to  fifty  cells  is 
required.  A  sponge  about  the  width  of  the  hand  and  ten 
or  twelve  inches  in  length  is  placed  upon  the  central  por- 


HOME    TREATMENT    OF    DYSPEPSIA.  329 

tion  of  the  spine.  Another  sponge  of  the  same  length, 
and  twice  as  wide,  is  applied  over  the  abdomen  opposite. 
As  strong  a  current  is  passed  as  can  be  endured  by  the 
patient  without  severe  pain  or  injury  to  the  skin.  The 
sponges  should  be  well  moistened,  and  should  be 
closely  adapted  to  the  skin.  Clay  electrodes  secure 
better  contact  than  sponges. 

70.  Galvanization  of  the  Sympathetic 
Nerve. — A  galvanic  battery  is  required  as  indicated 
in  69.  A  sponge  the  size  of  the  hand  is  placed  at  the 
back  of  the  neck,  and  another  twice  as  large  is  placed 
over  the  umbilicus  or  the  epigastrium.  A  current  as 
strong  as  the  patient  can  bear  without  injury  to  the 
skin  is  applied  from  ten  to  twenty  minutes. 

The  Rest-Cure.  —  A  course  of  rest-cure  treat- 
ment is  indicated  in  cases  in  which  there  is  excessive 
nervous  irritability,  combined  with  nervous  exhaus- 
tion, and  especially  in  cases  in  which  emaciation  is  a 
prominent  symptom.  Rest-cure  should  be  followed 
by  "General  Nutritive  Treatment,"  and  afterward  by 
' '  General  Tonic  Treatment, ' '  for  which  it  is  a  prepa- 
ration. 

FORM  A. 

1.  Absolute  rest  in  bed,  with  exclusion  of  friends, 
is  demanded.     The  patient  should  be  kept  quiet,  and 
encouraged  to  exercise  the  mind  as  little  as  possible,  to 
sleep  all  he  can,  and  to  rest  both  physically  and  mentally. 

2.  The  patient  should  take  four  meals  a  day, — two 
major  and  two  minor, —  the  major  meals  preferably  at 
8  A.  M.  and  3  p.   M.  ;  the  minor  meals  at  12  M.  and 
7  P.  M.,  and    should  eat  as  much  as  can  be  digested. 
The  major  meals   may  consist  of  any  of  the  articles 


330  THE    STOMACH. 

included  in  Diet  Lists  Nos.  3,  9,  and  10.  The  minor 
meals  should  be  confined  to  the  articles  found  in  Diet 
Lists  5  and  6,  or  such  foods  as  are  very  quickly  digested. 

In  cases  in  which  the  digestion  is  very  much  im- 
paired, it  is  better  to  confine  the  diet  chiefly  to  kurny- 
zoon  or  buttermilk,  and  eggs.  Bromose  and  granose 
(Diet  List  No.  25)  are  also  especially  useful  in  these 
cases.  Bromose  may  be  taken  as  a  substitute  for  milk 
in  cases  in  which  milk  does  not  agree  well  with  the 
stomach.  It  is  a  most  excellent  food  for  the  minor 
meals.  When  obtainable,  granose  should  be  used  at 
the  major  meals  as  a  means  of  regulating  the  bowels. 

The  patient  should,  on  awakening  each  morning, 
have  dry  friction  applied  to  the  whole  surface  of  the 
body  by  the  hand,  or,  better,  with  a  rough  towel  or 
a  soft  flesh-brush.  At  10  A.  M.,  hot  and  cold  applica- 
tions should  be  made  to  the  spine  (18),  to  be  followed 
by  a  tepid  sponge  bath  (1).  Massage  (36),  at  first 
very  light,  should  be  applied  writh  increasing  vigor 
from  day  to  day.  After  the  first  week,  the  muscles 
may  be  exercised  by  flexion  and  extension  of  the  arms 
and  legs,  the  patient  making  resistance  (see  Figs.  32 
and  33).  The  bowels  should  be  moved  daily  by  means 
of  the  enema  (22),  if  necessary.  The  action  of  the 
stomach  and  bowels  should  be  encouraged  by  massage 
of  the  stomach  (31)  and  kneading  of  the  bowels  (30). 
Symptoms  of  indigestion  should  receive  attention  as 
elsewhere  recommended. 

FORM  B. —  MODIFIED  REST-CURE. 

The  same  measures  recommended  in  Form  A  should 
be  employed,  but  the  patient  should  be  given  a  little 


HOME    TREATMENT    OF    DYSPEPSIA.  331 

exercise  out  of  doors  for  an  hour  or  two  daily  in  a 
wheel-chair,  or  at  first  lying  upon  a  cot.  After  a  few 
days  the  patient  may  be  allowed  to  walk  a  little,  but 
should  spend  at  least  half  the  time  each  day  in  bed. 

FORM  C. 

The  measures  recommended  for  "General  Nutri- 
tive Treatment, ' '  combined  with  rest  in  bed  the  greater 
part  of  the  time,  should  be  employed. 

General  Nutritive  Treatment.  —  The  pur- 
pose of  nutritive  treatment  is  to  improve  the  patient's 
nutrition  by  increasing  the  demand  for  food,  hence  the 
appetite,  and  thus  enlarging  the  store  of  food  and  blood 
in  the  body  without  overtaxing  the  nervous  system. 
Nutritive  treatment  is  required  in  the  case  of  very 
young  and  very  old  persons. 

The  following  series  of  prescriptions  are  progress- 
ive. Feeble  patients  should  begin  with  A ;  while 
strong  patients  may  begin  with  B,  or  even  C.  The 
patient  should  be  promoted  at  the  end  of  one,  two,  or 
three  weeks,  to  the  next  prescription,  and  after  com- 
pleting this  nutritive  series,  should  begin  the  tonic 
series,  page  333. 

A. 

Fomentation  over  the  stomach  and  liver  every 
morning  before  rising,  to  be  followed  three  times  a 
week  by  a  tepid  sponge  bath  (90°  F.),  rubbing  with 
oil,  and  on  other  days  by  dry  friction  with  a  soft  flesh- 
brush  or  a  coarse  towel. 

General  massage  and  massage  of  the  stomach, 
bowels,  and  liver,  about  10  A.  M.  daily. 


332  THE    STOMACH. 

A  short,  warm  full  bath,  with  soap  shampoo,  fol- 
lowed by  an  oil  rub,  taken  just  before  retiring  at  night, 
once  a  week. 

Carriage  riding,  walking,  bicycle  riding,  or  other 
exercise  in  the  open  air  suited  to  the  patient's  strength, 
from  one  to  three  hours  daily. 

Sun  bath  five  to  fifteen  minutes  daily,  or  whenever 
possible. 

Swedish  movements  (39,  A),  daily. 

Breathing  exercises  before  and  after  each  meal. 

One  or  two  hours'  rest  in  a  horizontal  position  be- 
fore dinner. 

B. 

Warm  full  bath  (95°  F.),  with  a  cold  pour  over  the 
spine  and  the  liver  twice  a  week.  The  bath  should  be 
cooled  to  80°  F.  for  ten  or  fifteen  seconds  at  the  close, 
and  followed  with  an  oil  rub.  This  bath  is  best  taken 
at  night  just  before  retiring. 

Hot  and  cold  sponging  of  the  spine  for  ten  or 
fifteen  minutes  every  morning,  followed  by  a  tepid 
sponge  bath  (85°  F.)  and  an  oil  rub,  with  hacking 
over  spine  and  liver. 

Soap  shampoo  once  a  week. 

Sun  bath,  out-of-door  exercise,  and  massage  as  in  A. 

Swedish  movements  (39,  B). 

C. 

Short  vapor,  Turkish,  or  hot-air  bath,  or  a  wet- 
sheet  pack  continuing  twenty  to  thirty  minutes,  twice 
a  week,  followed  by  an  oil  rub  at  about  10  A.  M.  or  at 
night  just  before  retiring. 


HOME    TREATMENT    OF    DYSPEPSIA. 

Fomentations  to  the  spine  for  fifteen  minutes,  fol- 
lowed by  a  cool  (75°  F.)  sponge  bath  and  an  oil  rub 
every  morning. 

Swedish  movements  (39,  B). 

Exercise,  sun  baths,  and  massage  as  in  A,  with  in- 
creased vigor. 

General  Tonic  Treatment. —  One  of  the  es- 
sential features  of  tonic  treatment  is  the  application  of 
cold  water.  Water  is  one  of  the  best  of  all  tonics. 
This  treatment  is  indicated  in  cases  of  general  debility, 
anemia,  and  most  forms  of  chronic  disease.  It  is  only 
contra-indicated  in  the  cases  of  feeble,  very  young, 
and  aged  persons,  and  in  those  in  whom  there  is  a 
high  degree  of  irritability  or  excitability.  The  treat- 
ment should  be  made  progressive.  The  feeble  patient 
should  begin  with  A,  being  promoted  at  the  end  of  two 
or  three  weeks  to  B,  and  later  to  0.  After  completing 
the  entire  series,  the  patient  may  advantageously  con- 
tinue some  of  the  measures  recommended, as  a  regular 
habit,  particularly  the  cool  morning  sponge  or  shower 
bath,  followed  by  vigorous  rubbing,  and  the  regular 
daily  exercise  out  of  doors. 

A. 

Hot  sponging  of  the  spine,  a  cool  (80°  F.)  towel  or 
sponge  bath  every  morning  before  rising,  followed  by 
hacking  of  the  spine,  spatting  of  the  general  surface, 
and  oil  rubbing. 

At  10  A.  M.  general  massage  or  Swedish  move- 
ments. 

General  applications  of  electricity  —  faradic  (66)  or 
sinusoidal  (67)  —  daily. 


33-i  THE    STOMACH. 

Swedish  movements  (39,  A). 

Exercise  out  of  doors,  carriage  riding,  horseback 
riding,  bicycle  riding,  according  to  the  patient's 
strength,  daily  from  two  to  four  hours. 

B. 

In  addition  to  A,  the  patient  should  three  times 
a  week  take  fomentations  over  the  stomach  and  liver, 
followed  by  a  rubbing  wet-sheet.  This  treatment  may 
be  given  at  bedtime,  unless  the  patient  is  apt  to  be 
greatly  fatigued  at  night.  In  such  cases  it  should  be 
taken  earlier  in  the  day,  but  not  within  two  hours  of 
a  meal. 

Swedish  movements  (39,  B). 

C. 

The  patient  should  take,  each  morning,  a  fomenta- 
tion over  the  abdomen,  hot  and  cold  sponging  of  the 
spine,  a  cold  (75°  F.)  sponge  bath,  followed  by  an 
oil  rub,  hacking  over  the  spine  and  liver,  and  general 
massage. 

At  10  A.  M.  or  at  bedtime,  three  times  a  week,  a 
cold  wet-sheet  pack  for  twenty  to  thirty  minutes,  fol- 
lowed by  a  rubbing  wet-sheet  and  an  oil  rub. 

Swedish  movements,  general  applications  of  elec- 
tricity, massage,  and  out-of-door  exercise  as  in  A 
and  B. 

Mechanical  Swedish  Movements. -- For 
many  years  I  have  made  use  of  mechanical  means 
in  the  treatment  of  indigestion  and  constipation.  Pa- 
tients under  my  care  have  derived  special  benefit  from 
the  use  of  the  vibrating  chair,  the  kneading  apparatus, 


FlG.  1.— Apparatus  for  Kneading  1  he  Abdomen 


FIG.  3.    -Mechanical  Respii-.u  inn. 
PLATK   VIII. 


HOME   TREATMENT    OF    DYSPEPSIA.  335 

and  the  trunk-shaking,  apparatus,  which  are  illustrated 
in  Plates  VII  and  VIII.  The  following  description 
of  these  machines  is  copied  from  the  author' s  work, 
"The  Art  of  Massage,"  previously  mentioned  :  — 

"  The  Vibrating  Chair.— Fig.  2,  Plate  VII,  rep- 
resents a  vibrating  chair  devised  by  the  author  in  1883, 
and  in  constant  use  since  that  time  at  the  Battle  Creek 
Sanitarium.  The  usual  rate  of  vibration  employed  is 
twenty  per  second.  A  person  needs  to  experience  but 
a  single  application  to  become  convinced  of  the  power- 
ful physiological  effects  which  may  be  produced  by 
mechanical  vibration.  When  seated  in  the  chair, 
strong  vibratory  movements  are  experienced,  in  which 
the  whole  body  takes  part.  The  greatest  amount  of 
force  is  applied  to  the  lower  portion  of  the  trunk. 
The  vibratory  impulses  communicated  are  felt-  power- 
fully in  the  lower  bowel,  and  have  a  decided  stimulat- 
ing effect  upon  the  rectum. 

"Mechanical  Kneading.—  Mechanical  kneading  of 
the  abdomen  is  one  of  the  most  useful  of  the  several 
forms  of  kneading  ;  indeed,  it  may  perhaps  with  justice 
be  said  to  be  the  most  useful  of  all.  It  is  best  admin- 
istered by  means  of  the  apparatus  shown  in  Fig.  1, 
Plate  VIII.  This  apparatus,  which  the  writer  had 
constructed  for  the  purpose  several  years  ago  (1883), 
and  has  had  in  constant  use  since,  consists  of  a  table 
with  a  large  aperture  near  the  center  of  the  top.  In 
this  opening  plays  a  series  of  six  vertically  placed  bars, 
each  surmounted  by  a  suitable  pad.  Each  bar  is  sepa- 
rately actuated  by  a  cam,  or  eccentric,  so  that  it  has  its 
own  independent  motion.  These  six  eccentrics  are  so 
arranged  as  to  give  a  wave-like  form' to  the'  combined 
22 


336  THE    STOMACH. 

movements  of  the  six  kneading  pads.  Simultaneously 
with  the  vertical  movement  of  this  kneading  device, 
the  table-top,  with  the  patient  which  it  bears,  is  made 
to  move  back  and  forth,  thus  changing  the  relation  of 
the  pads  to  the  abdominal  surface,  and  causing  them 
to  knead  the  entire  abdomen.  The  two  sets  of  move- 
ments are  so  tuned  that  the  wave-like  kneading  move- 
ment is  made  to  follow  very  closely  the  course  of  the 
colon,  thus  bringing  this  part  of  the  intestine  especially 
under  control. 

'-'•Trunk  Rolling. —  The  apparatus  represented  in 
use  in  Fig.  1,  Plate  VII,  consists  of  a  pair  of  pulleys 
moving  in  alternation  and  in  opposite  directions,  a 
fraction  of  a  revolution  in  each  direction.  To  each 
pulley  is  attached  one  end  of  a  broad  strap,  which  is 
passed  around  the  trunk  in  such  a  manner  that,  as  the 
strap  is  pulled  first  in  one  direction  and  then  in  the 
opposite,  the  tissues  are  acted  upon  very  much  as  in 
certain  forms  of  palmar  kneading.  When  applied 
about  the  waist,  it  is  a  very  excellent  means  of  admin- 
istering a  rolling  movement  to  the  muscles  of  the 
trunk,  and  a  shaking  movement  to  the  viscera  ;  when 
applied  to  the  shoulders,  the  effect  is  that  <Jf  deep 
kneading.  This  apparatus,  devised  by  the  author 
about  ten  years  ago,  is  a  favorite  with  patients  who 
are  under  treatment  by  mechanical  massage.  Its  ap- 
plication is  so  vigorous  that  it  is  not  continued  longer 
than  from  two  to  four  minutes. 

"  Pelvis  Tilting. — The  purpose  of  this  device  (Fig. 
3,  Plate  VII )  is  to  aid  in  restoring  the  prolapsed  organs 
to  a  normal  position.  The  apparatus  consists  of  a  tilt- 
ing table  which  moves  rhythmically  from  a  horizontal 


HOME   TREATMENT    OF    DYSPEPSIA.  337 

position  to  that  shown  in  the  cut,  in  which  the  position 
of  the  patient  is  such  as  to  cause  the  abdominal  organs 
to  be  dragged  upward  by  gravity.  It  is  very  useful 
in  relieving  pelvic  congestion  and  other  symptoms 
commonly  present  in  cases  in  which  the  pelvic  and 
abdominal  organs  are  prolapsed. 

"Mechanical  Respiration.  —  In  Fig.  3,  Plate  VIII, 
is  shown  an  apparatus  by  means  of  which  artificial  res- 
piration may  be  mechanically  administered.  In  its  use 
the  patient  is  seated  upon  a  stool,  the  arms  being  placed 
over  movable  rests,  which  fall  in  the  axillae.  The  back 
is  supported  by  a  padded  rest  placed  between  the  shoul- 
ders. When  the  machine  is  set  in  motion,  the  shoul- 
ders are  lifted  upward  and  backward  in  such  a  way  as 
to  expand  the  chest  in  an  efficient  manner,  producing 
a  strong  inspiratory  movement  quite  independent  of 
any  effort  on  the  part  of  the  patient.  The  effect  is  to 
correct  the  condition  known  as  flat  or  hollow  chest, 
and  to  give  flexibility  to  the  chest  walls  when  they 
have  become  rigid  in  consequence  of  insufficient  use. 
This  apparatus  is  in  part  modeled  after  a  similar  ar- 
rangement by  Zander,  but  several  improvements  have 
been  added  ;  among  others  being  a  device  by  means 
of  which  the  arms,  as  well  as  the  shoulders,  are  raised, 
thus  increasing  the  vigor  of  the  inspiratory  movement. 

"  Cannon- Ball  Massage. —  A  cannon-ball  covered 
with  leather  is  a  valuable  mechanical  accessory  in  the 
application  of  abdominal  massage.  A  ball  weighing 
from  four  to  six  pounds  is  usually  employed.  The  ball 
is  simply  rolled  upon  the  abdomen,  following  the 
course  of  the  colon  from  right  to  left.  I  have  found 
the  cannon-ball  very  useful  when  employed  in  connec- 


338  THE    STOMACH. 

tion  with  other  measures  of  treatment.  It  has  this 
advantage,  that  it  may  be  employed  by  the  patient 
himself.  It  should  be  used  for  fifteen  minutes  morn- 
ing and  evening.  In  the  morning  it  may  be  employed 
just  before  rising,  or  half  an  hour  after  breakfast."' 

Water-Drinking.  —  In  cases  of  obstinate  con- 
stipation, due  to  inactivity  of  the  liver,  water-drinking 
is  of  advantage,  if  the  stomach  will  bear  it.  The  quan- 
tity of  water  which  can  be  taken  will  vary  from  a  single 
glassful  before  breakfast  to  six  glassfuls  a  day  in  the 
intervals  between  meals.  Repeated  experiments  by 
the  most  eminent  physiologists  have  shown  that  the 
liberal  use  of  water  as  a  beverage  is  a  great  promoter 
of  vital  activity,  not  only  of  the  liver,  but  of  other  vital 
organs.  This  measure  must  not  be  carried  to  excess, 
however ;  it  should  be  discontinued  if  it  disturbs  di- 
gestion. 

Water-drinking  has  been  very  much  abused  within 
the  last  twelve  or  fifteen  years,  since  it  was  brought 
prominently  before  the  public  by  Dr.  Salisbury  and 
Dr.  Cutter,  of  New  lork.  In  cases  of  dilatation  of 
the  stomach,  which  is  very  common  among  dyspeptics, 
constituting  nearly  one  half  the  entire  number,  copious 
water-drinking  is  often  productive  of  great  mischief. 
The  dilated  stomach  being  unable  to  absorb  fluids 
rapidly,  and  retaining  for  a  long  time  the  large  quan- 
tity of  water  introduced,  becomes  abnormally  distended 
and  overweighted,  and  the  patient's  condition  is  thus 
aggravated  rather  than  benefited.  The  use  of  the 
stomach-tube  in  washing  out  the  stomach  largely  obvi- 
ates the  necessity  for  copious  water-drinking.  In  cases 
in  which  water-drinking  must  be  interdicted  on  account 


HOME   TREATMENT    OF    DYSPEPSIA.  339 

of  dilatation  of  the  stomach,  a  sufficient  amount  of 
moisture  may  be  supplied  by  slowly  introducing  a 
quart  or  two  of  water  into  the  colon  daily,  preferably 
at  night,  allowing  as  much  of  the  liquid  to  be  absorbed 
as  possible. 

The  Hunger-Cure. —  Fifty  years  ago  the  hunger- 
cure  was  much  practised  by  the  followers  of  Dr.  Joel 
Shew,  and  at  the  primitive  water-cures  which  were  at 
that  time  to  be  found  in  various  parts  of  the  Middle 
and  Eastern  States.  The  advocates  of  the  hunger-cure 
extolled  it  so  highly,  however,  and  used  it  so  indis- 
criminately, that  it  fell  into  disrepute,  and  fasting  is 
now  seldom  mentioned  as  a  mode  of  treatment.  How- 
ever, the  writer  is  of  the  opinion  that  abstinence  from 
food  is  one  of  the  most  important  and  valuable  of  cura- 
tive measures  in  a  great  variety  of  morbid  conditions, 
and  especially  in  certain  forms  of  indigestion. 

The  fasting  exploits  of  Drs.  Tanner  and  Griscom, 
who  abstained  from  food  for  forty  and  forty-two  days 
respectively,  and  of  the  Italian  faster  who,  in  London, 
under  conditions  of  strict  surveillance,  abstained  wholly 
from  food  for  the  full  period  of  sixty  days,  have  dissi- 
pated the  erroneous  notions  formerly  held  respecting 
the  immediate  necessity  of  food  as  a  condition  of  life. 
The  body  contains  within  itself  a  considerable  store  of 
nutrient  material,  upon  which  it  is  able  to  draw  in  case 
of  need. 

In  all  conditions  in  which  the  system  is  laboring 
under  the  influence  of  poisons  absorbed  from  the  ali- 
mentary canal,  abstinence  from  food  is  the  surest  and 
sometimes  an  indispensable  means  of  prompt  relief. 
These  intestinal  poisons  are  due  to  the  action  of  germs, 


3-JtO  THE    STOMACH. 

and  result  from  the  decomposition  of  food  substances 
consequent  upon  the  growth  and  development  of  mi- 
crobes. Germs,  like  other  living  organisms,  require 
food  for  growth.  The  quickest  method  of  getting  rid 
of  them  and  their  evil  effects,  is  to  starve  them  out  by 
abstinence. 

The  advantage  of  withholding  food  in  fever,  acute 
rheumatism,  and  inflammation  of  the  stomach  and 
bowels,  has  long  been  recognized.  Fasting  is  equally 
useful  in  many  cases  of  biliousness,  bilious  dyspepsia, 
and  dilatation  of  the  stomach.  Nothing  will  so  quickly 
relieve  an  attack  of  sick-headache  as  abstinence  from 
food.  Fasts  of  two  or  three  weeks'  duration,  as  prac- 
tised in  water-cures  half  a  century  ago.  are  not,  how- 
ever, to  be  recommended  ;  but  the  omission  of  a  meal 
when  one  feels  slightly  indisposed,  with  loss  of  appe- 
tite, and  perhaps  slight  headache,  will  often  prevent  a 
more  serious  illness,  and  quickly  restore  the  vital  equi- 
librium. A  number  of  years  ago  the  writer  succeeded 
in  effecting  a  cure  in  a  case  of  very  pronounced  dilata- 
tion of  the  stomach,  by  requiring  the  patient  to  abstain 
from  taking  food  by  the  mouth  for  two  weeks.  Nutri- 
tion was  maintained  by  means  of  the  nutritive  enema. 
At  the  end  of  the  two- weeks'  fast  the  stomach  was 
found  to  be  reduced  to  nearly  its  normal  dimensions. 

I  had  under  my  care  at  one  time  a  lady  who  many 
years  before  had  submitted  to  the  hunger-cure.  This 
patient  was  suffering  from  obstinate  constipation,  the 
result  of  prolapse  of  the  stomach  and  colon,  and  dilata- 
tion of  the  colon.  She  claimed  that  the  two-weeks' 
fast  which  she  had  undergone  some  twenty  years  be- 
fore, had  resulted  in  a  complete  cure  of  the  constipa- 


HOME    TREATMENT    OF    DYSPEPSIA.  341 

tion  for  more  than  twelve  years.  So  severe  a  measure 
is  not  necessary,  however,  in  cases  of  this  kind.  A 
proper  regulation  of  the  diet,  the  support  of  the  pro- 
lapsed viscera  by  a  suitable  abdominal  supporter  (Fig. 
40,  page  320),  and  the  employment  of  such  curative 
measures  as  electricity,  manual  Swedish  movements, 
gymnastics,  and  hydrotherapy,  will  suffice  to  effect  a 
cure,  if  employed  intelligently  and  perseveringly. 

Fasting  methods  can  very  easily  be  abused.  Pro- 
longed fasting  should  never  be  undertaken  without  the 
advice  and  careful  supervision  of  a  physician.  I  have, 
in  my  experience,  met  with  very  few  instances  in 
which  I  have  thought  it  proper  to  advise  a  prolonged 
fast,  but  have  in  a  great  number  of  cases  observed  de- 
cided benefit  as  the  result  of  omitting  a  few  meals,  or 
fasting  for  a  day  or  two. 

Great  benefit  may  be  received  from  what  might  be 
termed  a  partial  fast,  in  which  the  patient  subsists 
wholly  upon  some  one  simple  article  of  food  taken  in 
moderate  quantity.  Fruit,  as  ripe  apples,  grapes,  or 
peaches,  is  best  suited  for  this  purpose.  The  effect  of 
such  a  regimen,  which  may  be  followed  for  a  week 
without  injury,  providing  the  patient  is  resting,  is  to 
purify  the  general  system  in  a  wonderful  manner,  first, 
by  preventing,  through  the  destruction  of  microbes,  the 
production  of  poisons  in  the  alimentary  canal,  which 
overtax  the  liver  in  their  destruction,  and  the  kidneys 
in  their  elimination  ;  and,  second,  by  encouraging  the 
activity  of  the  kidneys  in  removing  impurities  from  the 
blood.  Fruit  is  a  natural  diuretic. 

Healthful  Dress. —  As  has  already  been  men- 
tioned, dress  is  a  matter  of  no  small  consequence  in 


342  THE    STOMACH. 

the  treatment  of  chronic  dyspepsia.  Any  pressure 
upon  the  stomach  "is  highly  injurious.  Men,  as  well 
as  women,  frequently  suffer  injury  from  constrict-  of 
the  waist,  in  supporting  their  clothing  by  means  of  a 
belt.  The  writer  has  met  with  two  cases  of  floating 
kidney  in  men,  in  which  the  condition  was  evidently 
due  to  contraction  of  the  waist.  In  one  case  a  black- 
smith had  usually  supported  his  clothing  by  means 
of  his  leather  apron-strings  tied  tightly  about  his 
waist.  In  the  other  case  an  army  officer  had  been 
injured  in  the  same  manner  by  the  constriction  of  his 
sword-belt. 

The  clothing  should  fit  the  body  so  loosely  that 
there  will  be  ample  room  for  full  expansion  of  the 
chest  at  the  waist ;  otherwise,  with  each  inhalation 
the  stomach  is  crowded  down  out  of  position.  The 
clothing  should  be  wholly  suspended  from  the  shoul- 
ders, not  merely  by  straps,  but  by  waists  ;  or  it  is  still 
better  to  wear  what  are  known  as  ' '  union  garments, ' '  in 
which  the  upper  and  lower  garments  are  united  in  one. 
Plates  IX  and  X  show  some  excellent  designs  for 
healthful  dress  for  women  which  have  been  designed 
in  the  Dress  Department  of  the  Battle  Creek  Sani- 
tarium, from  which  patterns  may  be  obtained. 

In  addition  to  wearing  the  clothing  loose  enough 
to  give  every  organ  perfect  freedom  of  action,  it  is  of 
the  greatest  importance  that  the  extremities  be  kept 
thoroughly  warm.  Cold  hands  and  feet  are  very  com- 
mon with  dyspeptics.  It  will  generally  be  found  best 
to  wear  flannel  undergarments  throughout  the  year, 
graduating  the  thickness  to  the  temperature.  In  ex- 
treme cases  of  disturbed  circulation,  it  may  be  neces-. 


FIG.  2.— Freedom  Waist  with  Skirt. 


FIG.  3.—  Norfolk  Jacket  with 
of  Business  Suit- 


PJ.AT; 


FIG.  4.— Woman's  Practical 
Business  Costume, 


Knickerbockers. 


FIG.  5.— Divided  Skirt  with 
Circular  Yoke  —  Front. 


FIG.  7.— Fijr.  4  Opened  in  Back 
to  Show  Divide. 


FIG.  6.— Divided  Skirt  with 
Circular  Yoke  —  Back. 


1  .y  Copjrighle 

FIG.  8.— Skirt  Waist 
—  Front. 


Fin.  10. -Skirt  with 
Circular  Yoke, 


FIG.  11.— Union 

Suit-Front. 

PLATE  X. 


Copyrighted. 


FIG.  9.— Skirt  Waist 
-  Back. 


FIG.  12.— Union 
Suit— Back. 


HOME    TREATMENT    OF    DYSPEPSIA.  343 

sary  to  change  the  clothing  once  or  twice  a  day  to 
accomplish  this. 

Sleeping. — It  is  of  great  importance  that  suffi- 
cient sleep  be  obtained  by  those  suffering  from  indi- 
gestion, though  sometimes  this  seems  impossible  on 
account  of  the  nervousness  occasioned  by  this  disease. 
It  is  generally  best  to  retire  early,  but  there  is  no  virtue 
in  getting  up  in  the  morning  at  an  early  hour  unless 
the  body  is  recuperated  by  rest.  Sleep  must  be  ob- 
tained, and  on  ma.ny  accounts  it  is  better  to  take  it  in 
the  forepart  of  the  night  ;  but  if  not  secured  then,  it 
should  be  taken  at  other  times.  Sleeplessness  induced 
by  anxiety  is  often  a  cause  of  dyspepsia.  It  is  a  great 
obstacle  in  the  way  of  successful 'treatment. 

It  is  an  excellent  practise  to  retire  for  rest  for  an 
hour  or  two  before  the  mid-day  meal.  Many  dyspep- 
tics are  able  by  this  means  to  recruit  sufficient  energy 
to  digest  the  second  meal,  while  otherwise  they  suffer 
from  indigestion  after  dinner,  although  capable  of  di- 
gesting breakfast  without  difficulty. 

Traveling.  —  Many  physicians  are  in  the  habit 
of  recommending  patients  upon  whom  they  have  ex- 
hausted their  skill,  to  seek  health  by  traveling.  Thou- 
sands annually  leave  their  homes,  and  at  great  expense 
visit  various  watering-places,  mineral  springs,  etc.,  in 
this  country  and  in  Europe,  in  accordance  with  such 
advice.  Some  return  much  benefited  ;  but  the  ma- 
jority are  no  better  except  for  the  rest.  This  is  due 
to  the  fact  that  traveling  does  not  remove  the  real 
cause  of  the  difficulty,  and  may  often  increase  it.  In 
general,  it  is  next  to  impossible  to  secure,  while  travel- 
ing, either  regularity  of  meals  or  other  habits,  or  a 


344  THE    STOMACH. 

proper  quality  of  food.  This,  of  course,  to  a  great 
degree  counteracts  the  benefit  which  might  otherwise- 
be  derived. 

The  advantage  of  special  climates  is  undoubtedly 
very  greatly  overrated,  though  a  cool  climate  may  gen- 
erally be  considered  as  best,  especially  for  those  suffer- 
ing with  bilious  dyspepsia.  With  nervous  dyspeptics, 
however,  a  warm  climate  seems  to  agree  better,  as  it 
occasions  less  disturbance  of  the  circulation. 

Mental  and  Moral  Treatment. — This  is  too 
important  a  part  of  a  successful  plan  of  treatment  to  be 
neglected.  The  gloomy  despondency  which  so  com- 
monly goes  with  this  disease,  must  be  steadily  combated 
by  a  determination  to  be  cheerful.  The  disposition  to 
fret  and  worry,  and  to  dwell  upon  the  unpleasant  or 
painful  features  of  one's  condition,  must  be  fought 
against  with  firmness  and  resolution.  The  dyspeptic 
who  allows  his  mind  constantly  to  dwell  upon  his 
stomach,  and  who  speculates  upon  the  probabilities 
respecting  the  digestion  of  each  morsel  of  food  as  he 
swallows  it,  will  be  certain  to  remain  a  dyspeptic. 
This  unfortunate  tendency  on  the  part  of  sufferers 
from  this  disease  is  a  great  impediment  to  recovery. 
The  mind  should  be  diverted  from  self  as  much  as 
possible  at  all  times,  and  especially  while  eating.  The 
habit  many  dyspeptics  have  of  talking  constantly  about 
themselves,  which  sometimes  amounts  almost  to  a 
monomania,  cannot  be  too  strongly  condemned.  Too 
great  solicitude  about  the  stomach,  the  diet,  etc.,  is 
worse  than  none  at  all, 


QUACKS  AND  NOSTRUMS. 


THERE  is  no  class  of  maladies  the  victims  of  which 
have  been  so  constantly  and  extensively  a  prey  to  the 
quack  and  the  patent-medicine  vender,  as  disorders  of 
the  stomach.  The  chronic  dyspeptic,  daily  tormented 
by  the  discomforts  of  his  malady,  eagerly  seeks  relief 
from  any  source,  and  is  readily  beguiled  by  the  decep- 
tive and  alluring  descriptions  of  newspaper  advertisers, 
patent  medicine  almanacs,  and  manufactured  testimoni- 
als, to  try  first  one  and  then  another  of  the  thousand 
and  one  nostrums  which  are  displayed  upon  the  drug- 
gist's shelves  and  catalogued  upon  country  barns  and 
fences.  Quite  a  large  proportion  of  dyspeptics  thus 
become  addicted  to  the  use  of  patent  medicines.  The 
writer  has  met  many  persons  who  might  very  justly 
be  termed  ' '  nostrum  maniacs. ' '  They  eagerly  scan 
every  newspaper  that  comes  into  their  hands  for  the 
announcement  of  some  new  medicine  of  this  kind,  and 
as  soon  as  possible  obtain  it  for  trial. 

The  great  charm  of  the  patent  medicine  is  the  se- 
crecy thrown  about  it,  and  the  idea  often  positively 
maintained  —  always  encouraged  —  by  the  manufac- 
turer, that  his  particular  nostrum  contains  some  newly 
discovered  remedy,  the  virtues  of  which  have  been  en- 
tirely unknown  to  scientific  medicine.  One  of  the  best 
means  of  dissipating  this  fallacy  is  to  expose  the  fact 

[345] 


346  THE    STOMACH. 

well  known  to  the  scientific  physician,  that  all  patent 
medicines  and  nostrums  are  either  inert  and  worthless, 
because  of  their  inefficiency  or  their  injurious  character, 
or  else  are  simply  cheap  and  well-known  drugs  with 
which  every  physician  is  familiar,  and  which  may  IK- 
obtained  from  any  druggist  for  a  very  small  fraction  of 
-the  price  charged  for  the  nostrum.  As  a  rule,  the  first 
cost  of  the  patent  medicine  is  scarcely  one  twentieth 
the  price  charged  for  it.  The  manufacturer  puts  his 
ill-gotten  gams  into  newspaper  advertisements  and 
huge  signs  painted  upon  board  fences,  barns,  rocks, 
and  conspicuous  .places  along  highways  and  railroads, 
instead  of  into  the  medicine  bottle.  For  an  expose  it 
is  only  necessary  to  publish  the  composition  of  these 
nostrums.  Here  are  a  few  of  them  :  — 

Stoughton  Bitters. —  Orange  peel,  6  oz. ;  gentian 
root,  8  oz. ;  Virginia  snake  root,  1£  oz. ;  American  saf- 
fron, -|  oz. ;  red  saunders,  ^  oz. ;  alcohol,  4  pts. ;  water, 
4  pts. 

Brown's  Iron  Bitters. —  Iron,  1  gr. ;  calisaya  bark, 
2  gr. ;  phosphorus,  1-200  gr. ;  coca,  1  gr. ;  viburnum 
prunifolium,  1  gr. 

Hop  Bitters. —  Hops,  4  oz. ;  orange  peel,  2  oz. ; 
cardamom,  2  dr. ;  cinnamon,  1  dr. ;  cloves,  %  dr-  '•>  alco- 
hol, 8  oz. ;  sherry  wine,  2  pts. ;  simple  sirup,  1  pt. ; 
water,  sufficient. 

Hostetter's  Bitters. —  These  bitters  contain,  accord- 
ing to  the  Medical  Bulletin,  the  following  ingredients  : 
Sugar,  2  Ibs. ;  calamus  root,  2  Ibs. ;  orange  peel,  2  Ibs. ; 
Peruvian  bark,  2  Ibs. ;  gentian  root,  2  Ibs.;  columbo 
root,  2  Ibs. ;  rhubarb,  8  oz. ;  cinnamon,  4  oz. ;  cloves, 
2  oz. ;  diluted  alcohol,  4  gals. 


QUACKS    AND    NOSTRUMS.  347 

German  Bitters. —  German  camomile,  2  oz. ;  sweet 
flag,  2  oz. ;  orris  root,  4  oz. ;  coriander  seed,  1^  oz. ; 
centaury,  1  oz. ;  orange  peel,  3  oz. ;  alcohol,  4  pts. ; 
water,  4  pts. ;  sugar,  4  oz. 

Stomach  Sitters. —  Gentian  root,  1^  oz. ;  cinchona 
bark,  ^  oz. ;  orange  peel,  2-|  oz. ;  cinnamon  cort.,  J  oz. ; 
anise  seed,  ^  oz. ;  coriander  seed,  %  oz. ;  cardamom  seed, 
%  oz. ;  gum  kino,  -J-  oz. ;  alcohol,  1  pt. ;  water,  4  qts. ; 
sugar,  1  Ib. 

French  Absinthe. —  Oil  wormwood,  1  dr. ;  oil  melisa, 
15  drops  ;  oil  anise,  2-|  dr.;  oil  star  anise,  2|-  dr.;  oil 
fennel,  ^  dr. ;  oil  coriander,  3  drof^  ;  alcohol,  14  pts. ; 
water,  6  pts. 

Vinegar  Hitters. —  The  following  is  Dr.  Gibbon's 
account  of  the  origin  of  Walker's  Vinegar  Bitters, 
a  specimen  of  which  the  writer  analyzed  several 
years  ago,  and  found  to  contain  five  per  cent,  of 
alcohol :  — 

' '  This  '  bitters '  is  one  of  the  nastiest  nostrums, 
and  is  introduced  and  largely  sold  by  the  most  exten- 
sive and  brazen  advertising  under  the  false  pretense  of 
being  free  from  alcohol.  It  originated  with  the  cook 
of  a  party  which  traveled  overland  as  a  mining  com- 
pany to  California  in  1849  ;  he  settled  in  Calaveras 
county,  and  having  no  success  as  a  miner,  turned  his 
attention  to  the  bitter'  qualities  of  the  herbs  growing 
about  him,  and  came  to  San  Francisco  with  the  idea  of 
making  and  vending  a  nostrum  to  be  called  '  Indian 
Vegetable  Bitters.'  He  fell  in  with  an  enterprising 
druggist,  who  saw  money  in  the  project,  and  joined 
him.  At  the  suggestion  of  the  latter,  the  '  Indian  ' 
was  struck  out,  and  as  the  concoction  got  sour  by  fer- 


348  -          THE    STOMACH. 

mentation,  it  was  concluded  to  call  it  '  Vinegar  Bitters,' 
and  to  identify  it  with  the  temperance  movement.  The 
native  herbs,  which  became  rather  troublesome  to  col- 
lect, were  discarded  ;  and  aloes,  being  a  cheap  bitter, 
was  substituted.  l  Nine  sick  people  out  of  ten, '  said 
the  druggist,  '  will  be  cured  by  purging, '  therefore  the 
aloes  and  Glauber's  salt.  So  the  cook  turned  doctor, 
the  decoction  became  sour,  and  of  Californian  instead 
of  Indian  paternity,  and  l  Dr.  Walker's  Vinegar  Bitters' 
began  its  career  in  the  newspapers  and  on  the  shelves 
of  the  drug-stores." 

The  statement  has  recently  been  made  that  ' '  Vine- 
gar Bitters  "  is  now  manufactured  of  sour  beer  and 
aloes. 

Lees  Anti-Bilious  Pills. —  Calomel,  36  gr. ;  jalap, 
60  gr. ;  gamboge,  12  gr. ;  tartar  emetic,  3  gr. 

Tropic  Fruit  Laxative. —  Jalap,  powdered,  5  parts  ; 
senna,  powdered,  5  parts  ;  sugar,  5  parts  ;  tamarind 
pulp  (E.  L),  30  parts. 

Carter 's  Little  Liver  Pills. —  Podophyllin,  1£  gr. ; 
aloes  (Socotrine),  3£  gr. ;  mucilage  of  acacia,  sufficient. 

Simon's  Liver  Regulator.  —  Hepatica,  1  oz. ;  lep- 
tandra,  1  oz. ;  serpentaria,  1  oz. ;  senna,  1£  oz. 

Radwayrs  .Regulating,  Pills.- — Each  box  contains 
from  twenty-nine  to  thirty-one  sugar-coated  pills  of 
unequal  size.  They"  consist  of  30  grains  of  aloes,  15 
grains  of  jalap,  8  grains  of  gamboge,  and-  some  inert 
substance. 

Fno^s  Fruit  Salt. —  Soda  bicarbonate, '16 8  parts; 
tartaric  acid,  150  parts  ;  Rochelle  salt,  110  parts. 

Hamburg  Tea. —  This  is  composed  of  senna  leaves 
and  stems,  coriander  fruits,  manna,  and  tartaric  acid. 


QUACKS    AND    NOSTRUMS.  349 

Garfield  Tea. —  This  consists  chiefly  of  senna  leaves 
and  couch  grass. 

Holloway' 's  Pills. —  Aloes,  2  dr.;  rhubarb,  1  dr.; 
capsicum,  20  gr. ;  saffron,  5  gr. ;  sulphate  of  soda,  5  gr. 

Hamburg  Drops. — Powdered  Socotrine  (aloes),  1|- 
oz. ;  American  saffron,  •§•  oz. ;  tincture  of  myrrh,  16  oz. 

B.  V.  Pierces  Pleasant  Purgative  Pellets. —  Each 
little  bottle  contains  from  twenty-eight  to  thirty-six 
small  sugar-coated  pills  of  unequal  size,  and  weighing, 
in  all,  from  eighteen  to  twenty-two  grains.  Their  ca- 
thartic effect  is  due  solely  to  podophyllin,  the  resin  of 
the  root  of  the  May-apple. 

Dr.  HalVs  So-called  "  Secret."  -For  several 
years,  a  man  styling  himself  Dr.  A.  Wilford  Hall, 
of  New  York  City,  has  been  advertising  and  vending 
about  the  country  a  pamphlet  purporting  to  disclose  a 
discovery  made  by  himself  something  more  than  forty 
years  t  ago.  The  so-called  discovery  of  Dr.  Hall' s  is 
this :  — 

Having  had  dyspepsia  for  a  number  of  years,  and 
being  greatly  troubled  with  constipation,  he  resorted  to 
the  enema  as  a  means  of  emptying  his  bowels,  and 
discovered,  as  he  asserts,  that  it  was  possible  to  inject 
a  gallon  of  water  into  his  colon  by  means  of  a  bulb 
syringe. 

This  is  the  whole  of  Dr.  Hall's  so-called  discovery. 
He  recommends  the  enema  as  a  substitute  for  nature's 
method  of  relieving  the  bowels,  to  be  employed  by  all 
persons,  sick  or  well,  and  claims  that  persons  who  will 
adopt  this  method  of  relieving  the  bowels,  will  be  proof 
against  most  of  the  diseases  to  which  human  flesh  is 
heir,  mentioning  particularly  such  disorders  as  Bright' s 
23 


350  THE    STOMACH. 

disease  of  the  kidneys,  smallpox,  and  other  grave  and 
contagious  maladies.  This  so-called  discovery  is  em- 
bodied by  Dr.  Hall  in  a  cheaply  printed  pamphlet  cost- 
ing about  two  cents,  for  which  he  charges  the  modest 
sum  of  four  dollars. 

Some  three  or  four  years  ago,  the  writer,  in  the 
magazine  of  which  he  is  editor,  Good  Health,  exposed 
in  a  most  thorough  manner  the  fraud  perpetrated  by 
Dr.  Hall  in  professing  to  be  the  discoverer  of  the 
enema  as  a  mode  of  emptying  the  bowels.  Whoever 
was  the  discoverer  of  this  method  of  mechanically  mov- 
ing the  bowels,  it  certainly  was  not  Dr.  Hall.  Dr. 
Shew,  a  water-cure  physician,  advocated  the  method 
in  this  country  some  years  before  Dr.  Hall  professed 
to  have  made  the  discovery,  and  Preissnitz  had  em- 
ployed it  long  before.  The  enema  may  be  properly 
used  as  a  means  of  emptying  the  bowels  when  they  are 
not  emptied  by  the  unaided  efforts  of  nature,  and  is 
preferable  to  the  habitual  use  of  laxatives  or  cathartics 
of  any  sort  ;  but  the  practise  of  daily  introducing  a 
large  quantity  of  water  into  the  alimentary  canal,  has 
the  effect  to  destroy  the  normal  sensibility  of  the 
bowels,  and  to  establish  an  abnormal  condition,  so 
that  this  large  amount  of  water  becomes  necessary  as 
a  stimulus  to  provoke  an  evacuation  of  the  intestines. 

It  was  long  ago  discovered  by  physicians  that  the 
habitual  use  of  the  enema  as  a  means  of  stimulating 
the  movement  of  the  bowels,  is  by  no  means  free  from 
evil  consequences.  Chronic  constipation  cannot  be 
cured  by  this  method  any  more  than  by  the  use  of 
cathartics.  It  is  only  a  mechanical  means  of  emptying 
the  bowels,  which  is  undoubtedly  preferable  to  the  re- 


QUACKS    AND    NOSTRUMS.  351 

tention  of  fecal  matter  ;  but  at  the  same  time  it  is  not 
a  cure  of  the  morbid  condition,  and  a  person  who  habit- 
ually uses  the  enema  becomes  as  much  dependent  upon 
it  as  is  the  habitual  user  of  mineral  water  or  pills,  upon 
these  agents. 

A  person  who  has  become  dependent  upon  the 
enema  as  a  means  of  moving  the  bowels  in  consequence 
of  following  the  erroneous  teachings  of  Dr.  Hall,  may 
find  relief  by  the  employment  of  the  graduated  enema 
(24-),  massage  of  the  bowels  (30),  and  the  Swedish 
movements  recommended  for  constipation  (43),  to- 
gether with  the  adoption  of  other  measures  which  are 
elsewhere  recommended  for  the  relief  of  constipation 
(see  page  279). 

It  may  be  added  that  the  author's  exposure  of  Dr. 
Hall's  fraudulent  claims  resulted  in  destroying  his  ne- 
farious business,  in  this  country  at  least,  but  he  suc- 
ceeded in  pocketing  a  hundred  thousand  dollars  or 
more  before  his  business  was  interrupted  by  the  pub- 
lication of  his  so-called  "secret." 


CC 
l-li 


GRAPHIC   METHOD. 


Explanation  of  the  Author's  Graphic  flode  of  Rep- 
resenting the  Results  of  Stomach  Work  Ob- 
tained from  the  Examination  of  the  Stomach 
Fluid  by  the  System  of  Investigation  Employed 
in  the  Hygienic  and  Physiological  Research 
Laboratories  of  the  Sanitarium  at  Battle  Creek, 
flich.,  U.  S.  A. 


IN  this  scheme  for  the  graphic  representation  of  the 
results  of  the  analysis  of  stomach  fluids  (Plate  XI), 
the  first  five  columns  relate  to  the  work  done  by  the 
.  stomach  in  as  many  different  phases  of  its  digestive 
and  chemical  activity.  The  remaining  columns  are 
devoted  to  the  coefficients  of  digestive  work,  by  refer- 
ence to  which  one  may  see  at  a  glance  the  relation  of 
the  work  done,  in  quantity  or  quality,  to  the  normal 
standard.  The  figures  in  the  several  columns  repre- 
sent, at  the  bottom,  the  lowest  figures,  and  at  the  top, 
the  highest  figures,  which  have  been  observed  in  the 
examination  of  more  than  five  thousand  stomach  fluids. 
The  figures  included  in  the  dark-colored  band  which 
passes  across  the  center  of  the  chart,  represent  the  nor- 
mal limit.  The  significance  of  the  figures  shown  in  the 
several  columns  is  as  follows  :  — 

The  letter  A'  indicates  the  total  work  done  by  the 
stomach  in  setting  free  the  hydrochloric  acid  necessary 

[352] 

' 


GRAPHIC    REPRESENTATION 

Of  the  Results  of  the  Chemical  Examination  of  [Salivary  and  Gastric  Digestion,  Based  upon  the  Study 

of  over  5000  Cases  in  the  Physiological  Laboratory  of  the  Battle  Creek  iHich.)  Sanitarium. 

Case  of  ARRANGED  BY 

A' 

H 

Froo  UP! 

C 

Combined 

A 

Total 

S 

Starch 

COEFFICIENTS    OF   DIGESTIVE  WORK. 

Chlorine 
Liberation. 

Fermentation. 

Siirch 
Digution. 

Saliiar) 
»ctint|. 

Solution. 

(bsorplioo. 

Chlorine. 

Acidity. 

Digestion. 

m 

a 

X 

b 

C 

y 

Z 

.430 

.240 

.410 

.480 

7.00 

2.00 

6.00 

100 

2.00 

10.00 

2.00 

6.00 

.4.10 

.225 

.390 

.440 

6.50 

1.90 

5.00 

so 

1.90 

9.00 

1,'j'o 

5.00 

.390 

.210 

.370 

.410 

6.25 

1.80 

4.50 

60 

1.80 

8.00 

l.'SO, 

4.00 

.37Q 

.195 

.350 

.385 

6.00 

1.70 

4.00 

50 

1.70 

7.00 

Ii70', 

3.00 

.350\ 

.ISO 

.330 

.360 

5.75 

1.65 

3.50 

4ft 

^l.Ap 

6.00 

i.65  o 

2.50   • 

.335' 
.320 

t  .165 
\.150 

.315 
.30,0- 

.340 
•'.340 

5.50 
5.25 

i.fco 

3.00 
2.75 

20 
'  5 

1.60 
1.55\ 

5.50 
5.00 

#.60S 
fi.-j'i  ^ 

2.25  £ 

2.00  a 

.305 

1135 

,^85 

.80*5 

5.00 

i.'s'p 

2.50 

JO 

1.50  ' 

4.50 

1.75  o 

.290 

."120, 

'.270 

.290 

4.75 

IN  45 

2.25 

:  to 

1.45 

,  4.00 

jtf'fy  i 

•  1.50  M 

.275 

.1'J.tf 

.255 

.275 

4.50 

i.4rt 

2.00 

6 

'1.40 

•  3.5ft/ 

.'  l.4a  5 

'.1.40  a 

.260 

.100 

.240 

.260; 

4.25 

ji.35'. 

1.75 

4 

\.35 

yo 

'  1.35V 

Vl.35  | 

.245 

.090 

.225 

.245', 

4.00 

,1.30'. 

1.50 

12 

1\30 

£50  , 

1.30  I 

1|.30  * 

.230 

.080 

.210 

.2301 

3.75 

,'1.25  'J 

1.40 

fo 

l.lfi 

/2;00  " 

1.25    ) 

t25 

.220 

.070 

.200 

.220 

3.50 

;i.2o 

1.30 

1.20\, 

l\~  ' 

1.20 

^  1*20 

1  .210 

.060 

.190 

.210 

'.3.25 

1.15 

',1.20 

U.15/ 

1.15 

\1.\5 

,  .200 

.050 

.ISO 

.200 

',3.00 

1.10 

J.10 

ll4 

lif 

\i.sp 

1.10 

1.10 

.  1  9.V 

.044 

,.174 

.195 

'£.75< 

1.05 

t.Or, 

1/2 

\(fi 

1.05 

A05 

o     .o:ss 

IS      .!!)() 

>^~'IH  i.fWsj 

fi.oo//|w|  i.fto 

l.VOr, 

1.00 

i.Vo 

:  .185 

.031 

.liil 

.ISy' 

Jj.8j3r 

.95 

1.95 

.94V 

**     <),) 

.'•V 

.ISO 

.025 

.155 

.ISO 

2/0<J 

.90 

.85 

,     .90 

\  .85 

!?o  '] 

4 

.8\ 

.90 

.85 

.170 

.024 

.145 

.170 

v?5p\ 

I  .160 

.023 

.135 

.160 

A.Vy* 

^    .80 

',.80 

/.60 

S 

.80 

j  .150 
I  .140 

.022 
.021 

.125 
.115 

.150 
.140 

'  1.20 

\.75 
\.70 

'.75 

/  .50 
.40 

\    "I**  <^ 
.   .70  a 

.75 

.70  z 

j  .130 
'   .120 

.020 
.018 
.016 
.014 

.105 

/,« 

'.075 

.ISO/ 

^.120; 

.100 

1.00 
.90 
.80 
.70 

\65 

V 

.56 

.50 

.0?' 
.60 
.55 
.50 

.30 
.25 
.20 
.15 

\.65S 

\.6oi 

\"  !2 
">0? 
,50  > 

\.co| 

!  .085  i 
.070 

.012 

1  .065 
.055 

.085 
.070 

.60 
.50 

.45 
.40 

.45 

.40 

.12 
.10 

Sol 

:kl 

.055 

'^Pr 

.045 

.055 

.40 

.35 

.35 

.08 

.45  £ 

.33* 

.040 

.006 

.035 

.040 

.30 

.30 

.30 

.06 

.*>4 

.30 

.025 

.004 

.025 

.025 

/20s 

s  .20 

.20 

.04 

.20 

-.20 

.040 

.002 

JU& 

.010, 

'    .10 

*V10 

.10 

.02 

.10 

.10 

.000 

"".OW 

.000 

^DOO7 

.00 

.Oft" 

.00 

.00 

.00 

.00 

m 

a 

b 

C 

y 

Z 

PLATE   XI. 


&KAPHIC    METHOD.  353 

for  digestion.  If  the  figures  found  by  analysis  fall 
below  the  normal  limits,  that  is,  below  .180,  the  case 
is  one  of  hypopepsia  ;  in  other  words,  the  stomach 
does  less  than  the  normal  amount  of  work.  If  the 
zero  point  is  reached,  the  case  is  one  of  apepsia,  and 
the  stomach  is  doing  no  digestive  work  whatever.  If 
the  figures  fall  above  the  normal  limit,  that  is,  above 
.200,  the  case  is  one  of  hyperpepsia  ;  in  other  words, 
the  stomach  does  more  than  the  normal  amount  of 
work. 

In  the  treatment  of  apepsia  and  hypopepsia,  all 
proper  means  are  used  to  increase  the  activity  of  the 
gastric  glands,  thereby  supplying  the  deficiency  of 
hydrochloric  acid.  The  principal  means  to  be  adopted 
are,  heat  over  the  stomach,  massage,  electricity,  the 
moist  abdominal  bandage,  exercise  after  eating,  a  hot 
and  cold  douche  over  the  stomach. 

In  cases  of  hyperpepsia,  or  excessive  formation  of 
hydrochloric  acid,  the  aim  of  the  treatment  adminis- 
tered is  to  lessen  the  glandular  activity  of  the  stomach. 
It  should  consist  of  hot  sponging  of  the  spine  ;  an  ice 
bag  over  the  stomach  in  extreme  cases  ;  galvanism  to 
the  spine,  the  stomach,  and  the  pneumogastric  nerve  ; 
and  the  avoidance  of  all  stimulating  foods  and  con- 
diments. 

The  figures  of  the  second  column,  H,  relate  to  the 
amount  of  free  hydrochloric  acid  present  in  the  stomach 
fluid.  When  it  is  remembered  that  free  HC1  is  neces- 
sary, not  only  as  an  aid  to  digestion,  but  as  a  means  of 
preventing  the  growth  of  germs  and  the  production  of 
pojgonous  substances  through  the  decomposition  of  the 
food,  the  importance  of  this  determination  will  be  ap- 


354  THE    STOMACH. 

predated.  Free  hydrochloric  acid  may  be  absent,  defi- 
cient, or  present  in  either  normal  quantity  or  in  excess, 
in  both  hypopepsia  and  hyperpepsia,  as  well  as  in  cases 
in  which  the  total  amount  of  work  done  by  the  stomach 
is  normal,  the  chief  departure  from  the  normal  standard 
being  some  form  of  acid  fermentation. 

Column  A,  which  has  relation  to  the  total  acidity 
of  the  stomach  contents,  has  the  same  normal  limit  as 
A'.  Outside  of  the  normal  limits,  however,  there  is 
often  a  wide  contrast  between  the  figures  shown  in 
these  two  columns.  The  total  acidity  may  be  either 
greater  or  less  than  the  sum  of  the  free  hydrochloric 
acid  (HC1)  and  the  combined  chlorin  (C).  When 
greater,  the  indication  is  that  acids  are  present  in  the 
stomach  which  have  been  formed  by  fermentation. 
When  less  than  the  normal  amount,  the  indication  is 
that  the  products  of  digestion  are  of  an  inferior 
quality. 

A  deficiency  of  free  HC1  requires  stimulation  of  the 
gastric  glands,  and  in  some  extreme  cases  benefit  is 
derived  from  the  administration  of  small  quantities  of 
HC1  with  a  little  diluted  water.  When  the  HC1  is  in 
excess,  patients  often  suffer  pain  or  sympathetic  nervous 
disturbances.  The  total  acidity,  A,  compared  with  A', 
is  a  good  means  of  determining  the  quality  of  the  di- 
gestive work  done. 

Column  S  represents  the  quality  of  maltose,  or  di- 
gested sugar,  found  in  the  stomach  for  each  100  c.c., 
or  three  and  one  half  ounces,  of  stomach  fluid.  A  defi- 
ciency indicates  either  an  excessively  acid  gastric  juice 
or  insufficient  mastication  of  the  food.  When  the^g- 
ures  found  are  above  normal,  the  indication  is  that  the 


GRAPHIC   METHOD,  355 

activity  of  salivary  digestion  has  been  unusually  great. 
This  is  a  condition  from  which  no  harm  can  arise. 

The  facts  which  the  author's  researches  have  elic- 
ited respecting  starch  digestion  are,  for  the  most  part, 
new.  They  are,  nevertheless,  important,  and  have 
excited  considerable  interest. 

The  Coefficients  of  Digestive  Work.  —  Of 
the  several  coefficients  of  digestive  work,  coefficient  a 
is  one  of  the  most  valuable  and  important.  When  be- 
low 1.00,  this  coefficient  indicates  an  inferior  quality  in 
the  digestive  product.  When  above  1.00,  the  indication 
is  that  there  are  present  other  acids  than  HC1  and  com- 
bined chlorin. 

Coefficient  b  relates  to  starch  digestion.  If  the 
figures  found  by  analysis  fall  below  the  normal  limit, 
1.00,  the  indication  is  that  a  smaller  amount  of  sugar  is 
formed  by  the  action  of  saliva  upon  the  starch  than  in 
the  normal  state.  This  difficulty  may  commonly  be 
remedied  .by  the  use  of  dry  food,  which  naturally  se- 
cures thorough  and  prolonged  mastication. 

The  figures  falling  below  1.00  in  column  c  indicate 
a  deficient  secretion  or  a  deficient  quality  of  saliva. 
Those  found  above  the  normal  line  indicate  an  unusual 
activity  or  abundance  of  salivary  secretion. 

Coefficient  y  has  relation  to  the  disintegration  or  di- 
vision of  food  into  fine  particles.  When  disintegration 
is  deficient,  as  shown  by  figures  below  1.00,  the  indica- 
tion is  for  the  use  of  dry  food  and  thorough  mastica- 
tion. Granose  is  admirably  adapted  to  these  cases. 

Low  figures  under  coefficient  z  represent  very  slow 
absorption.  Figures  which  fall  above  1.00  indicate 
an  unusually  rapid  absorption. 


356  THE    STOMACH. 

The  two  last-mentioned  coefficients, —  those  relating 
to  disintegration  and  absorption, —  especially  the  last- 
named,  or  coefficient  z,  are  less  exact  than  are  the 
other  coefficients,  yet  are  of  considerable  value,  if  pains 
is  taken  to  obtain  the  whole  quantity  of  fluid  contained 
in  the  stomach  at  the  end  of  an  hour  after  the  test 
meal  is  taken. 

Coefficient  m  has  relation  to  the  work  of  the  stom- 
ach in  producing  free  hydrochloric  acid  to  take  part 
with  pepsin  in  the  digestion  of  food.  In  hypopepsia, 
too  little  chlorin  is  set  free  ;  in  hyperpepsia,  too  much  ; 
in  apepsia,  none  at  all.  Improvement  in  hyperpepsia 
will  be  indicated  by  a  lowering  of  the  figures  represent- 
ing this  coefficient  ;  in  hypopepsia  and  apepsia,  the 
reverse. 

The  indications  derived  from  these  coefficients  are 
as  follows  :  — 

Coefficient  a  indicates  the  necessity  for  improve- 
ment in  the  quality  of  digestive  work  done.  Electric- 
ity, massage,  manual  and  mechanical  Swedish  move- 
ments, and  a  suitable  dietary,  especially  foods  contain- 
ing lactic  acid,  as  kumyss  or  kumyzoon,  buttermilk, 
etc.,  are  necessary.  Malted  gluten  and  granose  have 
also  proved  very  serviceable  in  improving  the  quality  of 
the  digested  products. 

A  high  coefficient  x,  or  a  and  x,  indicates  fer- 
mentation. A  dry  diet,  consisting  chiefly  of  granose 
and  fruits,  with  the  use  of  antiseptic  tablets,  is  gen- 
erally required  in  these  cases.  Stomach  washing  by 
means  of  lavage  is  also  required. 

A  low  coefficient  b  indicates  the  necessity  of  more 
thorough  mastication  or  the  withdrawal  of  starchy  food 


GKAPHIC    METHOD.  357 

from  the  dietary.  In  these  cases  a  fruit- and-nut  diet  or 
the  use  of  malted  gluten  is  found  to  be  of  very  great 
service.  In  some  cases  a  diet  consisting  chiefly  of 
kumyzoon,  kurnyss.  buttermilk,  eggs,  and  similar  foods 
must  be  resorted  to  for  a  time.  A  high  coefficient  b 
requires  no  attention. 

A  low  coefficient  c  may  result  from  gum-chewing 
or  tobacco-using,  the  constant  spitting  having  the  result 
of  weakening  the  salivary  glands.  The  application  of 
electricity  to  the  back  of  the  neck  and  at  the  pit  of  the 
stomach  is  often  useful  in  these  cases. 

A  low  coefficient  y  indicates  a  demand  for  more 
thorough  mastication,  and  perhaps  the  use  of  some 
thoroughly  disintegrated  food,  as  granose,  for  a  short 
time. 

Coefficient  z,  if  low,  indicates  the  necessity  of  ab- 
staining from  the  eating  of  liquid  foods  and  drinking 
at  meals.  Special  massage  or  manual  Swedish  move- 
ments must  be  adopted  as  a  means  of  increasing  the 
motor  activity  of  the  stomach.  Electricity  is  often 
useful  in  this  class  of  cases. 


INDEX. 


Abdomen,  galvanization  of,  328. 
Abdominal  bandage,  the  dry,  320. 
Abdominal  contents,  inspiratory 

lifting  of,  307. 
Abdominal  massage,  304. 
Abdominal  muscles,  exercises  to 

develop,  311. 

Abdominal  supporter,  320. 
Absinthe,  French,  347. 
A  bsorbents,  28. 

Acid,  hydrochloric,  26, 163,  323. 
Acid,  lactic,  26,  323. 
Acidity,  147,  162. 
Acidity,  calculated,  145. 
Acidity  from  hyperpepsia,  163. 
Acidity,  total,  145. 
Acne,  190. 
Albumen,  33. 
Alcohol,  114. 
Alimentary  canal,  21. 
Alkalies,  119. 
Almond,    sweet,    nutritive    value 

of,  42. 
Alum,  120. 
Ammonia,  120. 
Amylopsin,  30. 
Anal  itching,  153. 
Anemia,  Swedish  movements  for, 

315. 

Animal  foods,  31,  35. 
Anti-fat  dietary,  232. 
Antifebrin,  197. 
Antipyrin,  197. 
Apepsia,  142,  260. 
Aphthae,  181. 
Apoplexy,  nervous,  200. 
Appetite,  excessive,  152. 
Appetites,  perverted,  120. 
Apple,  dried,  nutritive  value  of,  41. 
Apple,  nutritive  value  of,  41. 
Apples,  time  of  digestion  of,  40. 
Apricot,  nutritive  value  of,  41. 


Aqua  salina,  324. 
Aseptic  dietary,  227. 
Asparagus,  nutritive  value  of,  42. 
Assyrians,  diet  of,  39. 
Asthma,  nervous,  154. 
Asthma  of  indigestion,  nocturnal, 
203. 

Backache,  20, 186. 

Baker's  bread,  92. 

Baking-powders,  119. 

Banana,  nutritive  value  of,  41. 

Barley  meal,  93. 

Barley,  nutritive  value  of,  41. 

Barley,  South  Russian,  nutritive 
value  of,  41. 

Barley,  time  of  digestion  of,  40. 

Bathing  after  meals,  78. 

Beans,  field,  nutritive  value  of,  42. 

Beans,  French  or  kidney,  nutritive 
value  of,  42. 

Beans,  Lima,  nutritive  value  of,  42. 

Beans,  pod,  boiled,  time  of  diges- 
tion of,  40.  • 

Beans,  string,  nutritive  value  of,  42. 

Beans,  white,  nutritive  value  of,  42. 

Beating,  152,  308. 

Beaumont,  Dr.,  109. 

Beef,  fat,  93. 

Beef,  lean,  93. 

Beef,  lean,  fried,  time  of  digestion 
of,  40. 

Beef,  lean,  nutritive  value  of.  42. 

Beef,  lean,  rare  roasted,  time  of 
digestion  of,  40. 

Beef,  salted,  boiled,  time  of  diges- 
tion of,  40. 

Beefsteak,  broiled,  time  of  diges- 
tion of,  40.  t 

Beef  tea,  99. 

Beer,  92. 

Beet,  nutritive  value  of,  42. 

[359] 


360 


THE    STOMACH. 


Beet,  sugar,  nutritive  value  of,  42. 

Belching,  157. 

Benzoin  solution,  325. 

Bernard,  103. 

Bicycle  riding,  134, 199. 

Bile,  29. 

Bile,  diminished  quantity  of,  102. 

Biliousness,  81, 177. 

Biscuit,  161. 

Bismuth,  subcarbonate  of,  325. 

Bismuth,  subgallate  of,  326. 

Blackberry,  nutritive  value  of,  41. 

Bouchard,  19,  70,  99. 

Bowels,  massage  of.  305. 

Bowels,  prolapsed,  Swedish  move- 
ments for,  317. 

Brain  work,  124. 

Bread,  barley,  nutritive  value 
of,  41. 

Bread,  corn,  time  of  digestion  of,  40. 

Bread,  fine-flour,  91. 

Bread,  raised,  161. 

Bread,  rye,  nutritive  value  of,  41. 

Bread,  Swedish  speine  lirod,  nutri- 
tive value  of,  41. 

Bread,  wheaten,  time  of  digestion 
of,  40. 

Bread,  white,  nutritive  value  of.  41. 

Bread,  whole-wheat,  nutritive 
value  of,  41. 

Breads,  unfermented,  235. 

Breath,  shortness  of,  154. 

Bright's  disease,  18, 108, 190. 

Brinton,  Dr.,  195.    ' 

Bromose,  241. 

Brown's  Iron  Bitters,  346. 

Buckwheat,  nutritive  value  of,  11. 

Burkart,  194. 

Burning,  152,  153,  154. 

Butter,  a5, 101, 103, 105. 

Butter,  French,  nutritive  value 
of,  42. 

Butter,  melted,  time  of  digestion 
of,  40. 

Buttermilk,  nutritive  value  of,  42. 

Butter,  Swedish,  nutritive  value 
of,  42. 

Butyric  acid.  164. 

Cabbage,  92. 

Cabbage,  boiled,  time  of  digestion 
of,  40. 


Cabbage,  raw,  time  of  digestion  of, 

40. 
Cabbage,   red,  nutritive  value  of, 

42. 
Cabbage,  white,  nutritive  value  of, 

42. 
Cabbage,  winter,  nutritive  value 

of,  42. 

Caffein,  114. 
Cancer  of  liver,  184. 
Cancer  of  stomach,  277. 
Cane-sugar,  33. 
Caramel-cereal,  241. 
Cardamoms,  109. 
Carrot,  nutritive  value  of,  42. 
Carrots,  92,  93. 

Carter's  Little  Liver  Pills,  348. 
Cascara  sagrada,  323. 
Casein,  33. 
Catarrh,  gastric,  184. 
Catarrh,  gastric,  diet  for.  2i,s. 
Catarrh,  intestinal,  184. 
Catarrh  of  stomach,  265. 
Catarrh  of  stomach,  chronic.  ','75. 
Cauliflower,   nutritive    value    uf, 

42. 

Celery,  nutritive  value  of,  42. 
Cellulose,  34. 
Chair,  vibrating,  335. 
Chalk,  121. 
Charcoal,  322. 
Charcoal  tablets,  322. 
Charcoal  tablets,  antiseptic,  323. 
Cheese,  35, 100,  161. 
Cheese,  Stilton,  nutritive  value  of, 

42. 

Cheese,  time  of  digestion  of,  40. 
Cherry,  dried,  nutritive  value  of, 

41. 

Cherry,  nutritive  value  of,  41. 
Chestnut,  nutritive  value  of,  42. 
Chicken  soup,  boiled,  time  of  di- 
gestion of,  40. 
Child,  food  for  a,  236. 
Chinese,  diet  of,  39. 
Chlorids,  fixed,  145. 
Chlorin,  combined,  145. 
Chlorin,  total,  145. 
Cinnamon,  109. 
Cinnamon  solution,  324. 
Circulation,  disturbance  of,  202. 
Cirrhosis  of  liver,  184. 


INDEX. 


361 


Clapotement,  131. 

Classification  of  digestions,  142. 

Clay-eaters,  120. 

Cloves,  109. 

Cocoanut,  nutritive  value  of,  42. 

Coefficients,  139,  355. 

Coldness,  152. 

Colic,  171. 

Coloclyster,  302. 

Colon,  the,  28. 

Colon,  the,  a  reservoir,  73. 

Colors,  unnatural,  154. 

Compression,  inspiratory,  308. 

Condiments,  34,  109. 

Confectionery,  67. 

Cookery,  bad,  94. 

Cooking,  98. 

Constipation,  69, 153, 184,  279. 

Constipation,  diet  for,  238. 

Constipation,  Swedish  movements 
for,  319. 

Constriction,  152,  153,  172. 

Consumption,  18. 

Consumption,  how  caused,  19. 

Corn  and  beans,  green,  time  of  di- 
gestion of,  40. 

Cornaro,  88. 

Corn,  dent,  nutritive  value  of,  41. 

Corn,  flint,  nutritive  value  of,  41. 

Corn-starch  or  arrow-root  gruel, 
91. 

Corn,  sweet,  nutritive  value  of,  41. 

Corsets,  123. 

Cow-tree,  milk  of,  nutritive  value 
of,  42. 

Cranberry,  nutritive  value  of,  41. 

Cream,  104. 

Cream,  nutritive  value  of,  42. 

Cream  tartar,  119. 

Cucumber,  nutritive  value  of,  42. 

Cucumbers,  111. 

Currant,  nutritive  value  of,  41. 

Date,  dried,  nutritive  value  of,  41. 

David,  19. 

Debove,  261. 

Dentifrice,  antiseptic,  324. 

Depression,  20, 153. 

Desserts,  87. 

Dextrin,  97. 

Diabetes,  107. 

Diabetes,  diet  for,  237. 


Diarrhea,  153,  185. 

Dickens,  Charles,  85. 

Diet  and  regimen,  224. 

Dietetic  rules,  224. 

Diet,  natural,  39. 

Diet  tables,  226. 

Diet,  unseasonable,  122. 

Digestion,  21. 

Digestion,  allowing  time  for,  74. 

Digestion  during  sleep,  70,  72. 

Digestibility  of  various  foods,  table 

of,  40. 

Dilatation  of  stomach,  19,  81. 
Dinners,  six  o'clock,  71. 
Discharges,  the,  153. 
Discontent,  124. 
Distention,  152. 
Douche,  liver,  300. 
Douche,  pail,  300. 
Dress,  healthful,  341. 
Drowsiness,  87, 153. 
Drowsiness,  unusual,  211. 
Drugs,  125. 
Dry  dietary,  228. 
Duck,  roasted,  time  of  digestion  of, 

40. 

Dujardin-Beaumetz,  70. 
Dyspepsia,  acid,  249. 
Dyspepsia,  bilious  or  foul,  251. 
Dyspepsia,  home  treatment  of,  287. 
Dyspepsia  in  America,  17. 
Dyspepsia,  infantile.  272. 
Dyspepsia,  inherited,  127. 
Dyspepsia,  nervous,  257. 
Dyspepsia,  painful,  253. 
Dyspepsia,  simple.  2-15. 
Dyspepsia,  symptoms  of,  149 
Dyspepsia,     Swedish     movements 

for,  318. 
Dyspepsia,  treatment  of,  221. 

Ears,  ringing  in,  154. 

Eating  between  meals,  67. 

Eating  late  at  night,  71. 

Eating  too  frequently,  66. 

Eating  too  little,  82. 

Eating  when  exhausted,  73. 

Economy  of  vegetable  food,  89. 

Eczema,  190. 

Eels,  vinegar,  113. 

Egg.  entire,  nutritive  value  of,  42. 

Eggs,  36,  92,  93,  :iJ2. 


362 


THE    STOMACH. 


Eggs,  fried,  time  of  digestion  of,  40. 
Eggs,  hard  boiled,  time  of  digestion 

of,  40. 

Eggs,  raw,  time  of  digestion  of,  40. 
Eggs,  soft  boiled,  time  of  digestion 

of,  40. 
Eggs,  whipped,  time  of  digestion 

of,  40.' 

Egg,  white  of,  nutritive  value  of.  42. 
Egg,  yolk  of,  nutritive  value  of,  42. 
Egyptians,  diet  of,  39. 
Enema,  301. 
Enema,  cold,  303. 
Enema,  graduated,  302. 
Enema,  laxative,  303. 
Enema,  oil,  304. 
Enemata,  nutritive,  240. 
Eno's  Fruit  Salt,  348. 
Epilepsy,  208. 
Eructations,  153. 
Esophagus.  25. 
Esophagus,  symptoms   pertaining 

to,  152. 

Exercise,  309. 
Exercise,  lack  of,  124. 
Exercises  to    develop    abdominal 

muscles,  218. 
Extracts,  flavoring,  122. 
Extremities,  cold,  20. 

Faintness,  66, 153. 

Faradic  electricity,  general  appli- 
cations of,  327. 

Fasting,  339. 

Fat,  40. 

Fat  and  blood  dietary,  233. 

Fats,  33. 

Fats,  abundant  use  of,  101. 

Feet,  cold,  191. 

Fermentation,  148, 159. 

Fever  diet,  234. 

Fidgets,  153. 

Fig,  dried,  nutritive  value  of,  41. 

Fish,  36. 

Fish,  white,  nutritive  value  of,  42. 

Flatulence,  156, 163. 

Flatulence,  intestinal,  157. 

Flesh,  36. 

Flesh  food,  242. 

Flesh  food,  excessive  use  of,  107. 

Flour,  arrow-root,  nutritive  value 
9f,41, 


Flour,  banana,  nutritive  value  of, 

41. 
Flour,  barley,  nutritive  value  of, 

41. 

Flour,  bean,  nutritive  value  of,  41. 
Flour,  buckwheat,  nutritive  value 

of,  41. 

Flour,  corn,  nutritive  value  of.  41. 
Flour,  family,  91. 
Flour,  graham,  nutritive  value  of, 

41. 

Flour,  oat,  nutritive  value  of,  41. 
Flour,  patent,  91. 
Flour,  pea,  nutritive  value-of,  41. 
Flour,  rye,  nutritive  vaiue  of,  41. 
Flours,  gluten,  92. 
Flour,  wheat,  nutritive  value  of, 

41. 

Flour,  whole-wheat,  91. 
Fomentation,  295. 

Fomentation,  mustard  or  turpen- 
tine, 296. 

Food,  adulterations  of.  1:M. 
Food  combinations,  77. 
Food,  decayed,  98. 
Food  elements,  32. 
Food  elements,  classification  of. :;-.'. 
Food  elements,  deficiency  in,  89. 
Food,  fermentation  of,  19. 
Food  for  brain  laborer,  84. 
Food  for  muscle  laborer,  84. 
Food,  fried,  95. 
Food,  quantity  of,  79. 
Food  producers,  31. 
Food,  proper  quantity  of,  85. 
Food,  quality  of,  94. 
Food,  salted.  111. 
Food,  soft,  100. 

Food,  too  many  varieties  of,  76. 
Food,  uncooked,  96 
Foods,  31,  34. 
Foods,  fermenting  or  decomposing, 

239. 

Foods,  raw,  96. 
Foods,  sterilized,  227. 
Foods,  vegetable,  31,  37. 
Foot  bath,  297. 
Fowl,  36. 
Fowl,  boiled,  time  of  digestion  of, 

40. 

Frogs,  37. 
Fruit,  green,  97, 


INDEX. 


363 


Fruits,  37,  233. 
Full  bath,  290. 
Full  bath,  hot  and  cold,  301. 

Gall-bladder,  the,  29. 

Gall-stones,  184. 

Galvanization  of  spine  and  .ab- 
domen, 328. 

Galvanization  of  sympathetic 
nerve,  329. 

Game,  36. 

Garfleld  Tea,  349. 

Gastric  juice,  26. 

Gastric  juice,  excess  of,  163. 

Gastritis,  diet  for,  238. 

Georges,  261. 

German  Bitters,  347. 

Germs  in  water,  129. 

Ginger,  34. 

Girdle,  wet,  294. 

Glands,  peptic,  25. 

Glenard,  Dr.,  216. 

Glucose,  33. 

Gluten,  35. 

Gluten  biscuit,  241. 

Gluttony,  80. 

Goflo,  241. 

Gooseberry,  nutritive  value  of,  41. 

Goose,  roasted,  time  of  digestion 
of,  40. 

Gormandizing,  77. 

Gout,  108. 

Graham  flour,  92. 

Granola,  240. 

Granose,  240. 

Grape,  nutritive  value  of,  41. 

Grape-sugar,  33. 

Graphic  method,  352. 

Gravies,  103. 

Greeks,  diet  of,  39. 

Griddle-cakes,  104. 

Gripes,  171. 

Guaiac  solution,  325. 

Hacking,  308. 

Hall's  so-called  "  Secret,"  349. 

Hamburg  Tea,  348. 

Hamburg  Drops,  349. 

Hand  bath,  289. 

Hazelnut,  nutritive  value  of,  42. 

HC1,  free,  145. 

Headache,  20, 153, 192. 


Headache,  nervous,  193. 

Health  foods,  240. 

Hearing,  disturbances  of,  209. 

Heartburn,  164. 

Heat,  dry,  296. 

Heaviness,  152, 153. 

Hiccough,  154. 

Hip  bath,  297. 

Holloway's  Pills,  349. 

Home  treatment  of  dyspepsia,  287. 

Honey,  nutritive  value  of,  42. 

Hop  Bitters,  346. 

Horseback  riding,  124. 

Hostetter's  Bitters,  346. 

Hot-air  bath,  299. 

Hunger,  152. 

Hunger-cure,  339. 

Hydrochloric  acid,  26, 163,  323. 

Hyperpepsia,  142,  264. 

Hyperpepsia,  acidity  from,  163,  323. 

Hypochondria,  173. 

Hypopepsia,  142,  260. 

Hysteria,  208. 

Iceland  moss,  nutritive  value  of,  41. 
Indian  meal,  92,  93. 
Indigestible  elements,  34. 
Indigestion,  intestinal,  268. 
Indigestion,  septic,  251. 
Indigestions,  classification  of,  150. 
Indigestions,  symptoms  of,  151. 
Infant,  food  for  a  bottle-fed,  235. 
Infant,  food  for  a  teething,  236. 
Infantile  dyspepsia,  272. 
Insanity,  18. 
Insomnia,  153. 
Intestinal  indigestion,  268. 
Intestinal  juice,  28. 
Intestine,  the  large,  28. 
Irritability,  153. 

Japanese,  diet  of,  39. 
Jaundice,  18, 184. 
Jaundice,  catarrhal,  107. 
Joint  movements,  308. 

Kidneys,  prolapsed,  Swedish  move- 
ments for,  317. 
Kneading,  304. 
Kneading,  mechanical,  335, 
Kumyzoon,  241. 


TUP:  STOMACH. 


Lactic  acid,  26. 

Lamb,  broiled,  time  of  digestion 

of,  40. 
Lapps,  165. 
Lard,  101. 
Lavage,  330. 

Lavage,  hot  and  cold,  322. 
Laxatives,  125,  323. 
Lean  meat,  92. 
Lee's  Anti-Bilious  Pills,  348. 
Lentils,  German,  nutritive  value 

of,  42. 

Lentils,  nutritive  value  of,  42. 
Letheby,  88. 

Lettuce,  nutritive  value  of,  42. 
Liquid  dietary,  234. 
Liver,  29. 

Liver,  cancer  of,  184. 
Liver,  cirrhosis  of,  184. 
Liver  pills,  125. 
Liver,  torpid,  269. 
Lobsters,  37. 

Macaroni,  nutritive  value  of,  41. 
Malarial  disease,  18. 
Malt  sugar,  or  maltose,  97. 
Man  a  frugivorous  animal, '96. 
Manna,  nutritive  value  of,  41. 
Massage,  304. 
Massage,  abdominal,  304. 
Massage,  cannon-ball,  337. 
Massage,  general,  308. 
Massage  of  bowels,  305. 
Massage  of  stomach,  306. 
Meals,  bathing  after,  78. 
Meals,  eating  between,  67. 
Meals,  irregularity  of,  67. 
Meals,  proper  number  of,  69. 
Meals,  sleeping  after,  75. 
Meals,  too  frequent,  66. 
Meat,  "  high,"  161. 
Meat,  raw,  108. 
Meats,  canned,  98. 
Mechanical  kneading,  335. 
Melon,  nutritive  value  of,  42. 
Memory,  loss  of,  153. 
Mental  impressions,  124. 
Mental  confusion,  153. 
Mental  disorders,  214. 
Mental  labor,  124. 
Mental  treatment,  344. 
Mexico,  110. 


Mirrobes  of  the  mouth,  19. 

Migraine,  177, 193. 

Migranin,  197. 

Milk,  35,  92,  93,  231. 

Milk  and  meat,  78. 

Milk  and  vegetables,  78. 

Milk,  boiled,  time  of  digestion  of, 

40. 

Milk,  cow's,  nutritive  value  of,  42. 
Milk-curdling  ferment,  30. 
Milk,  mother's,  nutritive  value  of, 

42. 
Milk  of  cow-tree,  nutritive  value 

of,  42. 

Milk,  raw,  time  of  digestion  of,  40. 
Milk,  skimmed,  nutritive  value  of, 

42. 

Milk-sugar,  33. 
Millet,  nutritive  value  of,  41. 
Mineral  waters,  126. 
Moral  treatment,  344. 
Mosso,  Dr.,  261. 
Motor  functions,  disturbances  of, 

153- 

Mouth,  22. 

Mouth,  antisepsis  of,  242. 
Mouth,  sour  taste  in,  163. 
Mouth,  symptoms  pertaining  to. 

152. 

Mustard,  34, 109. 
Mutton,  broiled,  time  of  digestion 

of,  40. 
Mutton,  lean,  nutritive  valui-  of, 

42. 
Mutton,  roasted,  time  of  digestion 

of,  40. 

Natural     Abdominal     Supporter, 

320. 

Nausea,  153, 166. 
Nervous  diseases,  210. 
Nervousness,  20,  153.-208. 
Nervous  symptoms,  207. 
Neurasthenia,  108. 
Neurasthenia,  gastric,  257. 
Newton,  85. 
New  Zealanders,  165. 
Niemyer,  Dr.,  195. 
Nitrogenous  dietary,  229. 
Nostrums,  345. 
Numbness,  154. 
Nutritive  treatment,  general,  331. 


INDEX. 


365 


Nut  butter,  241. 
Nut  cream,  105. 
Nut  meal.  241. 
Nuts,  104,  233.  234. 

Oatmeal,  92,  93. 

Oats,  nutritive  value  of,  41. 

Obesity,  107. 

Oil  rubbing,  304. 

Oils,  vegetable,  33. 

Onion,  nutritive  value  of,  4:3. 

Overeating,  80. 

Oysters,  37, 161. 

Oysters,  raw,  time  of  digestion  of, 

40. 
Oysters,  stewed,  time  of  digestion 

of,  40. 

Pain,  153, 173. 

Palpitation  of  the  heart,  154. 

Parkes,  88. 

Parsnip,  nutritive  value  of,  42. 

Parsnips,  92. 

Parsnips,  boiled,  time  of  digestion 

of,  40. 

Pasteur,  19. 
Pastry,  90. 

Peach,  nutritive  value  of,  41. 
Peach  pickles,  111. 
Peanut,  nutritive  value  of,  42. 
Pear,  dried,  nutritive  value  of,  41. 
Pear,  nutritive  value  of,  41. 
Peas,  92,  93. 
Peas,  African,  nutritive  value  of, 

42. 

Peasants,  diet  of,  39. 
Peas,  green,  garden,nutritive  value 

of,  42. 
Peas,    green,    shelled,    nutritive 

value  of,  42. 

Peas,  small,  nutritive  value  of,  42. 
Pelvis  tilting,  336. 
Pepper,  34, 109. 
Pepper,  Dr.,  194. 
Pepper-sauce,  34, 109. 
Pepsin,  19. 

Pepsin,  what  about?  261. 
Peptic  glands,  25. 
Peptogens,  38. 
Peptones,  19. 
Perfection  Vaporizer.  325. 

24 


Pickles,  111. 

Pie-crust,  103. 

Plants,  31. 

Plants,  pod-bearing,  38. 

Pleasant  Purgative  Pellets,  349. 

Plum,  nutritive  value  of,  41. 

Pork,  36. 

Pork,  nutritive  value  of,  42. 

Pork,  roasted,  time  of  digestion  of, 
40. 

Pork,  salted,  fried,  time  of  diges- 
tion of,  40. 

Portal  circulation,  51. 

Positions,  bad,  123. 

Potatoes,  92,  93. 

Potatoes,  Irish,  baked,  time  of  di- 
gestion of,  40. 

Potatoes,  Irish,  boiled,  time  of  di- 
gestion of,  40. 

Potato,  nutritive  vaiue  of,  42. 

Potato,  sweet,  nutritive  value  of, 
42. 

Poultry,  nutritive  value  of,  42. 

Pour,  hot  and  cold,  300. 

Prolapsed  colon,  Swedish  move- 
ments for,  317. 

Prolapsed  stomach,  Swedish  move- 
ments for,  317. 

Prune,  dried,  nutritive  value  of, 
41. 

Prune,  nutritive  value  of,  41. 

Ptomains,  19. 

Ptyalin,  22. 

Pugilists,  89. 

Pumpkin,  nutritive  value  of,  42. 

Pylorus,  26. 

Pyrosis,  165. 

Quacks,  345. 
Quantity  of  food,  79. 


Radway's  Regulating  Pills,  348. 
Raisin,  nutritive  value  of,  41. 
Raspberry,  nutritive  value  of,  41. 
Rectum,  symptoms  pertaining  to, 

153. 

Regurgitation,  153, 170. 
R<§mond,  261. 

Respiration,  mechanical,  337. 
Rest-cure,  329. 
Rheumatism,  108. 


366 


THE    STOMACH. 


Rheumatism   and   gout,   diet   for 

238. 

Rheumatism,  chronic,  19. 
Rice,  92,  93. 

Rice,  nutritive  value  of,  41. 
Rice,  time  of  digestion  of.  40. 
Roberts,  Dr.  William,  112. 
Romans,  diet  of,  39. 
Rowing,  124. 
Rubbing  wet-sheet,  292. 
Rumination,  or  merycism,  153,  170. 
Rye  meal,  92,  93. 
Rye,  German,  nutritive  value  of, 

41. 
Rye,   winter,   nutritive   value  of, 

41. 

Sago,  time  of  digestion  of,  40. 

Saleratus,  119. 

Saliva,  22. 

Salivary  digestion,  96. 

Salivary  glands,  22. 

Salmon,  nutritive  value  of,  42. 

Salmon,  salted,  boiled,  time  of  di- 
gestion of,  40. 

Salt,  109, 110. 

Salt  glow,  291. 

Salts,  32,  33. 

Salted  meats,  37. 

Saratoga  chips,  104. 

Sauerkraut,  161. 

Scurvy,  90. 

S«5e,  M.  Germaine,  93. 

Seltzer,  324. 

Sensation  of  fulness,  152. 

Sexual  abuses.  126. 

Shell-fish,  37,  99. 

Sighing,  154. 

Shower  bath,  291. 

Sight,  disturbances  of,  209. 

Simon's  Liver  Regulator,  348. 

Simple  dyspepsia,  142. 

Sinking  sensation,  173. 

Sinusoidal  current,  high  tension, 
327. 

Sinusoidal  current,  low  tension, 
328. 

Sirup,  nutritive  value  of,  42. 

Sitz  bath,  297. 

Skin,  dryness  of,  190. 

Skin  eruptions,  190. 

Sleeping.  343. 


Sleeping  after  meals.  75. 
Sleeplessness,  212. 
Small  intestine,  26. 
Smoked  meats,  37. 
Soda,  bicarbonate  of,  326. 
Soothing    Syrup    Mrs.    Winslow's, 

127. 

Soreness,  175. 
Soup,  bean,  time  of  digestion  of, 

40. 

Soup,  marrow -bone,  time  of  diges- 
tion of,  40. 
Soup,  mutton,  time  of  digestion  of, 

40. 

Spinach,  nutritive  value  of,  42. 
Spine,  galvanization  of,  328. 
Spine,  heat  and  cold  to,  299. 
Sponge  bath,  289. 
Squash,  nutritive  value  of,  42. 
Stammering,  153. 
Starch,  32,  40. 
Starch  digestion,  96. 
Starch  granules,  97. 
Starch  indigestion,  266. 
Starch,  raw,  97. 
Steapsin,  30. 
St.  Martin,  109. 
Stomach,  21,  25. 
Stomach  Bitters,  347. 
Stomach,  cancer  of,  277. 
Stomach,  catarrh  of,  265. 
Stomach,  chronic  catarrh  of,  275. 
Stomach     contents,    examination 

of,  134. 

Stomach  cough,  154,  205. 
Stomach,  dilatation  of,  19,  81,  215. 
Stomach  massage,  306. 
Stomach,  pressure  of,  123. 
Stomach,  prolapse  of,  216. 
Stomach,     prolapse    of,     Swedish 

movements  for.  317. 
Stomach,  symptoms  pertaining  to, 

152. 

Stomach-tube,  130,  321. 
Stomach,  ulceration  of,  diet   for, 

238. 

Stomach,  ulcer  of,  276. 
Stomach,  uneasiness  at,  155. 
Stools,  187.    ' 
Stools,  painful,  153. 
Stoughton  Bitters,  346. 
Strawberry,  nutritive  value  of,  41. 


INDEX. 


36T 


Strength,  eating  for,  237. 

Suet,  101. 

Sugar,  32,  40. 

Sugar,  use  of  in  excess,  105. 

Sulphur,  324. 

Sun  bath,  298. 

Suppers,  late,  71. 

Swedish  movements,  manual,  314. 

Swedish   movements,  mechanical, 

334. 

Sweetmeats,  67. 
Sympathetic  nerve,  galvanization 

of,  329. 
Symptoms,  general  nervous,  153. 

Tapeworm,  18. 

Tapioca,  time  of  digestion  of,  40.     - 

Tea  drunkenness,  90. 

Teeth,  22. 

Teeth,  permanent,  24. 

Teeth,  structure  of,  100. 

Teeth,  temporary,  23. 

Test  meal,  134. 

Thein,  114. 

Throat-ail,  182. 

Throat,  symptoms  pertaining  to, 

152. 

Tight  lacing,  123. 
Tightness,  172. 
Tingling,  154. 
Tobacco,  117. 

Tomato,  nutritive  value  of,  42. 
Tomatoes,  111. 

Tonic  treatment,  general,  333. 
Tongue,  appearance  of,  179. 
Tongue,  coated,  20. 
Tonsils,  22. 
Toxins,  19. 
Traveling,  343. 
Tropic  Fruit  Laxative,  348. 
Trout,  time  of  digestion  of,  40. 
Trunk  pack,  294. 
Trunk  pack,  hot  and  cold,  294. 
Trunk  rolling,  336. 
Trypsin,  30. 
Turkey,  domestic,  boiled,  time  of 

digestion  of,  40. 
Turkey,  roasted,  time  of  digestion 

of,  40. 
Turnip,  white,  nutritive  value  of, 

42. 
Turnips.  92. 


Turnips,  flat,  boiled,  time  of  diges- 
tion of,  40. 
Typhoid  fever,  18. 
Tyrotoxicon,  35. 

Ulcer  of  stomach,  276. 
Uric  acid  crystals,  189. 
Urine,  189. 
Urine,  scanty,  154. 

Van  Helmont,  124. 

Vapor  bath,  298. 

Veal,  broiled,  time  of  digestion  of, 

40. 
Veal,  fried,  time  of  digestion  of, 

40. 

Veal,  nutritive  value  of,  42. 
Vegetable  fats,  101. 
Vegetable  foods,  37. 
Vegetables,  38. 
Vegetables  and  legumes,  232. 
Vegetables,  raw,  97. 
Venison,  broiled,  time  of  digestion 

of,  40. 

Vibrating  chair,  335. 
Villi,  28. 

Vinegar,  34, 109, 112. 
Vinegar  Bitters,  347. 
Viscera,  replacement  of,  307. 
Vomiting,  153, 167. 

Walnut,  nutritive  value  of,  42. 

Water-brash,  98, 165. 

Water-drinking,  338. 

Water,  hard,  118. 

Water,  impure,  129. 

Weight,  172.' 

Wet-sheet  pack,  293. 

Wheat,  Japanese,  nutritive  value 

of,  41. 
Wheat,  Michigan,  Dlehle,  nutritive 

value  of,  41. 
Wheat,  Michigan,  white,  nutritive 

value  of,  41. 
Wheat,  Poland,  nutritive  value  of, 

41. 

Wheat  flour,  92. 
Wheat  meal  or  bread,  93. 
Whortleberry,  nutritive  value  of, 

41. 


368 


THE    STOMACH. 


Worcestershire  sauce,  34. 
Worms,  153. 
Worm  teas,  127. 
Worry,  124. 


Yeast,  150. 

Zwieback,  240. 

Zwieback,  nutritive  value  of,  41. 


THE  ART  OF  MASSAGE, 


By  J.  H.  KELLOGG,  M.  D. 


The  most  complete  and  thorough  work  upon  the  subject  of  massage 
ever  published.  Illustrated  by  139  cuts  and  10  finely  colored  anatom- 
ical plates.  Concise  directions  are  given  for  all  the  different  procedures  of 
scientific  massage.  It  ought  to  be  in  the  hands  of  every  nurse. 


The  Perfection  Vaporizer. 

THE   ONLY    PERFECT    INSTRUMENT   FOR   TREATING 
THE    NOSE,   THROAT,    AND    LUNGS. 

IS    especially  adapted    to   the 
treatment  of  diseases  of  the 
nose,    throat,    ear,    bronchial 
tubes,  and  lungs,  both  acute  and 
chronic.     Many  severe  spells  of 
sickness  can   be   avoided  by  its 
early  use.     Is  especialy   recom- 
mended in  "La  Grippe,"  when 
affecting   the   air   passages,  hay 
fever,  and  asthma. 

Full   directions   and   formulae 
with  each  instrument. 


PRICE,  BY  EXPRESS,  $3. 
POSTAGE,  35C.,  AT  PURCHASER'S  RISK. 


MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


The  accompanying  cut  represents  these  outline  Charts  mounted 
on  a  convenient  Exhibitor,  which  is  so  arranged  that  both  the  Charts 
and  the  Exhibitor  can  be  snugly  packed  in  a  compact  case. 


00 


i  2 
z  o 
i  n 
fr  w 

i 


THE  following  expression  regarding  the  value  of  Dr.  Kellogg' s 
"  Outline  Studies  of  the  Human  Body,"  is  from  Jay  W.  Seaver, 
A.  M.,  M.  D.,  President  of  the  Chautauqua  School  of  Physical  Edu- 
cation, and  Medical  Director  of  the  Yale  University  Gymnasium  :— 
"Dr.  Kellogg' s  'Outline  Studies'  I  am  sure  will  prove  to  be 
very  helpful  to  any  person  who  is  studying  the  human  body,  or  who 
is  teaching  personal  hygiene.     These  outlines  should  be  widely  in- 
troduced into  public  schools,  where  their  mere  presence  on  the  walls 
would  be  a  constant  object  lesson." 


M9DERN  MEBICINE  PaBLISHINS  GO., 
BATTLE  CREEK,  MICH. 


Something  Good 


to  Eat,  and 
Easy  to  Digest 


^GRANOSE, 


A  new  cereal  preparation  made  from  the  choicest  wheat,  by  a  process 
which  retains  all  the  elements  of  the  grain.  By  combining  the  proc- 
esses of  digestion,  cooking,  and  roasting,  by  the  use  of  special  machin- 
ery, the  wheat  is  brought  into  the  form  of  delicate  flakes,  in  which  the 
bran  is  thoroughly  disintegrated,  and  the  starch  largely  converted  into 
dextrine,  and  thus  made  ready  for  solution  by  the  digestive  juice  and 
for  prompt  assimilation. 


Is  crisp,  delicious,  appetizing,  and  digests  quicker  than  any 
other  cereal  preparation.  It  clears  off  the  tongue,  rids  the 
stomach  of  germs,  and  cures  constipation. 

It  is  unique  ;  an  incomparable  food.    Babies  thrive  upon  it. 


BATTLE  GREEK  SANITARIUM  HEALTH  FOOD  GO., 

Battle  Creek,  Mich. 

Antiseptic-  Charcoal 


••••  These  Tablets  consist  of  a  newly  pro- 
duced form  of  vegetable  charcoal, 
which  has  been  shown  by  experience  to  be  possessed  of  superior 
qualities,  with  which  are  combined  vegetable  digestive  agents 
and  intestinal  antiseptics  and  antiferments.  In  these  Tablets 
charcoal  is  for  the  first  time  presented  in  agreeable  form. 

When  to  be  Used. 

The  use  of  these  Tablets  is  indicated  in  all  cases  of  Stomach 
and  Intestinal  Indigestion,  and  especially  in  cases  in  which 
the  following  symptoms  are  present:  Sour  Stomach,  or  Acid 
Fermentation,  Bloating  of  the  Stomach  or  Bowels, 
Flatulence,  Eructations  of  Gas,  Foul  Tongue,  Bad 
Breath,  Unpleasant  Taste  in  the  flouth,  Biliousness, 
Sick  Headache,  Nervous  Headache,  and  Constipation. 

Dose:  One  to  four  Tablets  after  each  meal. 


MODERN  MEDICINE  CO.,  Battle  Greek,  Mien. 


Nut 


Thia  PreParation  is  made  from  carefully  se- 
lected  and  prepared  nuts.  It  represents  one 
of  the  most  nourishing  and  digestible  of  all 
the  food  products  of  the  vegetable  kingdom.  It  is  especially  adapted  for  pa- 
tients who  have  difficulty  in  digesting  starch,  and  for  those  who  need  to 
make  a  rapid  gain  in  flesh.  It  agrees  well  with  the  most  delicate  stomachs. 
and  will  often  be  digested  when  the  stomach  will  tolerate  nothing  else. 

Nut  Meal  may  be  eaten  dry,  or  combined  with  other  foods,  or  mixed 
with  a  little  hot  water,  when,  with  the  addition  of  a  little  salt,  it  makes  a 
delicious  soup  or  puree. 


Nut  Butter. 


A  capital  substitute  for  animal  fats  of 
all  sorts  in  the  seasoning  or  shorten- 
ing of  foods,  in  the  preparation  of  gra- 
vies, sauces,  etc.  Thoroughly  cooked  and  emulsified,  so  it  dissolves  readily 
in  water;  has  a  rich  nutty  flavor;  is  exceedingly  palatable  and  digestible, 
keeps  well,  is  thoroughly  sterilized,  and  free  from  all  objections  which 
can  be  urged  against  animal  fats.  It  gives  a  meaty  flavor  to  soups. 


Almond  Meal. 


This  is  simply  a  fine  meal  pre- 
pared from  the  choicest 
blanched  almonds,  especially  de- 
signed for  diabetics  and  invalids  who  cannot  digest  starch.  It  is  highly 
nutritious,  exceedingly  delicate  and  palatable,  and  an  admirable  food  for 
those  who  need  to  make  a  gain  in  flesh. 


Malted  Gluten 


furnishes  the  farinaceous  food 
elements  in  a  state  of  complete 
digestion,  READY  FOR  IM- 
MEDIATE ABSORPTION.  The  gluten  which  it  contains  has  been  subjected 
to  malt  digestion,  and  is  in  a  state  of  fine  division,  so  that  it  is  promptly 
acted  upon  by  the  digestive  fluids.  Gluten  is  of  all  food  elements  the  only 
one  which  is  capable  of  sustaining  life  indefinitely.  It  will  thus  be  seen 
that  MALTED  GLUTEN  IS  A  PERFECT  BLOOD  AND  FLESH-MAKING 
FOOD.  It  is  free  from  the  unpleasant  flavor  of  the  various  meat  peptones, 
and  is  especially  adapted  to  those  cases  requiring  perfect  intestinal  asepsis, 
in  which  meat  peptones  and  meat  preparations  of  every  description  are  con- 
tra-indicated. It  has  proved  a  sovereign  remedy  in  cases  of  nervous  head- 
ache, sick  headache,  obstinate  nausea,  and  vomiting,  and  numerous  cases 
in  which  all  other  food  substances  were  rejected  by  the  stomach. 

Are  you  thin  ?    Have  you  hollow  cheeks,  hoi- 
low   eyes,   and   a   general    emaciated   appear- 
ance?   WOULD  YOU  LIKE  TO  BE  FAT?    We 
will  tell  you  how:  EAT  BROHOSE! 

BROMOSE,  an  exceedingly  palatable  food  preparation,  consists  of  cereals 
and  nuts,  in  which  the  starch  is  completely  digested,  the  nuts  perfectly 
cooked,  and  their  fat  emulsified.  It  is  thus  ready  for  immediate  assimila- 
tion. It  is  the  most  easily  digested  and  most  fattening  of  all  foods,  and  at 
the  same  time  rich  in  proteids,  and  hence  UNEQUALED  AS  A  TISSUE 
BUILDER. 

BROMOSE  makes  fat  and  blood  more  rapidly  than  any  other  food.  It 
is  the  food  par  excellence  for  blood,  brain,  and  nerves.  Invalids  whose 
troubles  are  due  to  the  fact  that  they  cannot  digest  the  starch  of  cereals  and 
vegetables,  find  in  BROMOSE  A  PANACEA.  Bromose  is  rich  in  salts,  as 
well  as  proteids  and  food  elements.  It  is  excellent  for  weak,  emaciated  in- 
valids, and  feeble  children. 


SANITAS  FOOD  COMPANY,  Battle  Creek,  Mich. 


Sanitarium  Medical  Battery, 


THE  ADVANTAGES  CLAIMED  FOR  THIS  BATTERY  ARE 


Efficiency,  Durability, 
Simplicity  of  Construction, 
Ease  of  Management, 
Cleanliness,  and  lastly, 
Small  Cost  of  Maintenance, 


THE   CELLS   HAVE  THE   FOL- 
LOWING  ADVANTAGES. 

The  elements  are  zinc  and  carbon. 

The  excitant  is  a  solution  of  muriate  of  ammonia  (sal  ammoniac) 

and  water. 

There  are  no  fumes  nor  strong  acids  to  corrode  battery  parts. 
They  will  run  for  medical   purposes  many  months  without  the 

slightest  attention. 

There  is  no  consumption  of  the  zinc  element  when  battery  is  at  rest. 
They  are  perfectly  sealed,  so  that  evaporation  is  impossible. 
High  electro-motive  force.    Small  internal  resistance.    Great  power 

of  recuperation. 

PRICE,  WITH    ELECTRODES,  COMPLETE,  $1O.OO. 


MODERN  MEDICINE  CO.,  Battle  Creek,  Mich. 


COMBINATION 


Water  Bottle  and  Fountain  Syringe. 


Bailie  and  Fountain  Syringe 


This  is  a  first-class  Fountain  Syringe,  which  may  be  quickly  changed  to  a  Water 
Bottle  by  detaching  the  tubing  and  substituting  the  metal  cap. 


This  combination  was  first  arranged  by  us  a  number  of  years 
ago,  and  we  have  had  hundreds  manufactured  for  us.  We  have  re- 
cently arranged  for  the  manufacture,  for  our  special  trade,  of  this 
convenient  combination  in  an  improved  form.  It  consists  of  a  sub- 
stantial water  bottle  with  funnel  neck,  a  safe  and  durable  cap,  and 
six  feet  of  fine  improved  tubing,  with  suitable  attachments  for  con- 
necting with  the  bag.  An  outfit  of  the  usual  syringe  tubes  is  sup- 
plied with  the  syringe,  and  the  whole  is  packed  in  a  neat  and 
substantial  tin  box. 

PRICE,  complete,  $2.00. 

Postage,  25  cents. 

MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


EflR  DOOCHE. 


continuous  application  of  hot  water 
to  the  ear  is  a  most  valuable  means  of 
preventing  the  destructive  inflammation  and 
loss  of  hearing  in  cases  of  earache,  and  in  the  ear 
troubles  which  accompany  diphtheria,  measles,  and 
scarlet  fever.  The  objection  to  the  employment 
of  this  remedy  is  its  inconvenience.  This  device 
permits  of  the  application  of  a  continuous  stream 
of  hot  water  with  the  patient  in  any  position 
without  danger  of  wetting  the  clothing.  Its  timely 
use  will  often  save  life- long  inconvenience.  It  ought 
to  be  in  every  family. 


SPIME:  B-AGiS. 


RUBBER 
SPINE 
BAGS. 


Very  strong  and  durable  ;  essential  in  the  treatment  of  some  forms 
of  Dyspepsia,  Spinal  Irritation,  and  many  nervous  diseases. 

PRICE,  20  inch,  post=paid,   =  $1.40 

26  inch,  post=paid,        -        -          1.65 


STYLE 
A 


=  HOT-WATER  BAG. 


As  a  foot-warmer,  or  for  applications  of 
either  moist  or  dry  heat,  this  bag  is  invaluable. 
For  moist  heat,  wring  a  flannel  cloth  from  hot 
water  and  lay  on  the  bag.  It  is  a  durable 
article,  and  one  not  willingly  dispensed  with 
after  once  using. 

Price,  post=paid,  $1.50. 


MODERN  MEDICINE  CO., 

Battle  Creek,  Mich. 


IRiibber  ITce  Bags. 

THESE  bags  are  designed  for  making  applications  of  ice  to  the 
/  head,  throat,  or  spine.  Where  ice  cannot  be  obtained,  very  cold 
water  may  be  used.  It  avoids  the  necessity  for  wet  cloths,  which 
wet  the  patient's  clothing,  soil  the  bedding,  and  require  constant 
renewal.  The  mode  of  fastening  renders  the  bags  water-tight. 

PRICES. 

No.  i  ,  .....................  50  cents. 

No.  2  (narrower  than  No.  i),  speci- 

ally adapted  to  the  head,  50  cents. 

3.      Specially  adapted  to  the 
throat.     Made  of  pure  gum, 
and  furnished  at  the  follow- 
ing prices:— 
inches  long,  ......................  50  cents. 

inches  long,  ......................  60  cents. 

inches  long,  ......................  65  cents. 

inches  long  .......................  So  cents. 

Postage,  each,  4  cents. 


HEAD   BAGS. 


No. 


7 

8 

9 
ii 


Beneficial  results  may  often  be  obtained  by  the  use 
of  one  of  these  bags  in  cases  of  headache.  They  are 
very  light,  and  can  be  filled  with  either  hot  or  cold 
water.  They  are  easily  carried  and  readily  applied. 

Price,  32.00.      Postage,  5  cents. 


Instrument  for  the  Replication  of  fleat  to  the  Uagina. 


HALF-SIZE 


The  instrument  above  shown  has  been  devised  for  the  purpose  of  applving 
dry  heat  to  the  vaginal  walls.  It  may  also  be  used  for  cold  applications,  or 
alternate  hot  and  cold  applications  to  this  region.  It  is  used  in  connection 
with  a  fountain  syringe,  a  current  being  passed  through  it  either  hot,  cold, 
or  alternately  hot  and  cold. 

PRICES:  No.  i,  $1.25  ;   No.  2,  $1.00;  No.  3,  75  cents. 

MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


THE  NATURAL  ABDOMINAL  SUPPORTER. 


Ought  to  be  worn  by  every 

woman  who  has  the 

shape  of  Fig.  i. 

Cures  backache,  headache,  drag- 
ging sensation,  and  many 
other  discomforts. 


FIG.  i. 


FIG.  2. 


,    IFOSTIF.SJLID,    £p5-OO- 


Clubs  and  Dumb- Bells 


By  the  use  of  these  the  muscles  can  be 
exercised  and  developed,  giving  vigor,  appetite, 
and  cheerfulness  to  the  user. 

SIZES :  1-2,  3-4,  1,  1 1-2,  2,  2  1-2,  3,  and  4  Ibs. 

The  y2  Ib.  is  adapted  to  the  use  of  children 
from  2  to  4  years  of  age.     The  fy,  from  4  to  8 
years  of  age.     Prices  given  on  application. 
We  furnish  outfits  for  home  gymnasiums  at  various  prices 
from  $10.00  upwards.     One  of  these  outfits  ought  to  be  in  every 
hjOme. 

SEND    FOR    CIRCULAR    AND    PRICES. 


MUSCLE    BEATERS. 


Simple,  cheap,  and  efficient  instruments  for 
securing  some  of  the  effects  of  massage.  By 
their  habitual  use  one  can  obtain  most  beneficial 
results  without  the  aid  of  an  expert. 

Price  of  Ball  Beater,  postpaid,     -      $1.40 
Price  of  4-flnger  Beater,  postpaid,       2.15 


MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


Umbilical  Belts. 

Made  to  order  of  any  size  desired. 
PRICE,   $1.50.     Postage,  4  cents. 

Air  Pillows. 

Air  Pillows  are  always  cool  and  restful.  They  can  be  adjusted 
at  will.  Just  the  thing  for  camping  out  or  traveling.  Can  be 
packed  in  small  space  by  letting  the 


air  out. 


PRICE, 


No.  i,  Sateen  cover,  9x13,        $1.60 

No.  3,        "  "        12  x  18,        2.50 

Postage,    15  cents. 


Invalid  Air  Cushions. 

These  cushions  are  unsurpassed  in  the 
comfort  they  afford  to  very  thin  persons  in 
sitting,  and  are  also  essential  as  a  means  of 
preventing  the  formation  of  bed-sores. 


PRICE, 

9  inches  in  diameter  (postage,   10  cents), 


12 

15 


15 

22 


$1.60 
1.85 

2.25 


Exhalation  Tube  for  Lung  Development. 


The  Exhalation  Tube  is  one  of  the  most  effective  means  for  lung  develop- 
ment. It  can  be  carried  in  the  pocket,  and  can  be  used  at  any  time  without 
interfering  with  other  occupations,  and  can  thus  be  made  to  act  continuously 
in  developing  the  lungs,  expanding  the  air-cells,  and  deepening  the  respiratory 
movements.  It  is  worth  many  times  its  weight  in  gold  to  a  consumptive,  or 
to  any  other  person  whose  lungs  are  weak. 

MODERN  MEDICINE  CO.,  Battle  Creek,  Mich. 


PERFECTION 

DOUCHE  APPARATUS 

4- 

THIS  apparatus  consists  of  a  pail 
for    water,    with    a    long    rubber 
tube,  and  a  convenient  becUpan. 
It  is  made  of  tin,  and  is  light,  dura- 
ble,   and    easily    cleaned    and    disin- 
fected. 

It  is  especially  useful  for  giving 
douches  in  cases  of  confinement,  and 
to  feeble  patients  who  cannot  be  removed  from  the 
bed. 

It  can  be  adjusted  under  the  hips  without  moving 
the  patient,  on  any  form  of  bed  or  mattress. 

Any  amount  of  water  can  be 
used,  the  water  running  out  as 
fast  as  it  runs  in.  To  start  the 
water  running,  close  the  rubber 
tube  by  folding  it  below  the  bulb, 
and  then  squeeze  the  bulb,  which 
will  at  once  fill  with  water  when 
released.  Then  open  the  tube,  and  the  stream  will 
continue  to  flow  till  the  pan  is  empty. 


RRICEI, 

Complete, $2.25. 

Douche  Pan,  without  fountain  or  tubes,      .       1.25. 
Sent  by  express. 

MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


RECTAL    IRRIGATOR. 


fHE  great  prevalence  of  diseases  of  the  rectum,  and  the  recognized  advantages 
of  hot  water  in  the  treatment  of  diseases  of   mucous  membranes,  led,  several 
years  ago,  to  the  invention  of  the  hard  rubber  rectal  irrigator,  of  which  the  in- 
ventor speaks  as  follows  : — 

"The  virtue  of  hot  water  as  an  agent  in  removing  the  thickenings  and  indurations 
which  result  from  chronic  congestions  and  inflammations  of  mucous  surfaces  and  con- 
tiguous parts,  has  long  been  recognized.  In  the  treatment  of  pelvic  in- 
durations resulting  from  cellulitis,  no  agent  is  so  potent  as  the  hot  water 
vaginal  douche.  Dr.  Emmett  states  that  he  regards  this  one  agent  as 
more  valuable  than  all  other  local  measures  combined.  The  value  of 
hot  water  in  the  treatment  of  rectal  diseases  seems  to  have  been  less 
appreciated  by  the  profession,  though  recently  it  has  been  used  by  va- 
rious specialists,  and  with  excellent  results. 

"For  some  years  I  have  used  hot  water  by  means  of  the  continuous 
enema,  and  with  most  excellent  results;  but  feeling  the  need  of  some  better 
mode  of  applying  hot  water  to  this  part  of  the  body,  I  have  experi- 
mented with  various  forms  of  instruments  for  the  purpose.  All  the  in- 
struments I  found  in  use  were  too  large  to  be  used  without  discomfort, 
in  most  cases,  and  all  were  made  of  metal,  which  is  wholly  unfit  for  this 
purpose  on  account  of  its  great  conductivity  of  heat.  The  mucous  mem- 
brane is  much  more  tolerant  of  heat  than  is  the  skin.  When  a  metallic 
instrument  is  used,  the  heat  transmitted  to  the  very  sensitive  surface  at 
the  junction  of  the  skin  and  mucous  membrane  becomes  unbearable  be- 
fore the  temperature  is  high  enough  to  make  the  application  of  much 
value.  I  have  had  made  an  instrument,  which  I  believe  embodies  the 
excellencies  of  instruments  previously  made,  and  several  additional  ad- 
vantages, chiefly  the  following:  — 

"I.  It  is  made  of  hard  rubber,  a  poor  conductor  of  heat,  which  al- 
lows the  use  of  water  as  hot  as  the  mucous  membrane  will  tolerate. 

"2.    The  instrument  is  of  such  size  that  it  can  be  easily  used  even  in 
those  cases  in  which  there  is  unnatural  contraction  of  the  sphincter  muscles 
from  the  irritation  of  a  rectal  ulcer  or  fissure,  the  class  of  cases  in  which 
an  instrument  of  this  sort  is  of  greatest  service,  and  in  which  other  in- 
struments can  seldom  be  used,  never  with  water  of  proper  temperature. 
"3.    The  sleeve  of  the  instrument  is  notched  at  its  outer  extremity 
so  as  to  prevent  obstruction  to  the  return  flow  when  the  inner  tube  is  pushed  in  as  far 
as  is  allowed  by  the  stop. 

"I  have  used  this  instrument  in  the  treatment  of  hundreds  of  cases  of  rectal  dis- 
eases of  various  sorts,  and  have  found  it  a  most  satisfactory  and  effective  aid  in  the 
management  of  this  class  of  diseases." 

CAN    BE    USED    WITH    ANY    SYRINGE. 

Directions  for  use  accompany  each  Instrument. 

PRICE,  postage  paid,  $1.00.   With  Iniursal  Syphon  Syringe,  $2.25 ;  postage  15  cts. additional- 


MODERN  MEDICINE  CO.,  BATTLE  CREEK,  MICH. 


Date 

6W5 


University  of  California 
* 


07  5 


ue,  Los  Angeles,  CA  90024-1388 
Return  this  material  to  the  library 
from  which  it  was  borrowed. 


PRINTED   IN   U.«.».  CAT.     NO.     24      161 


A  000  51 1  632  2 


Kellogg,  John  H 
The  stomach 


WI  113 

K29s 

1896 


Kellogg,  John  H 
The  stomach 


WI  113 

K29s 

1896 


MEDICAL  SCIENCES  LIBRARY 

UNIVERSITY  OF  CALIFORNIA,  IRVINE 

IRVINE,  CALIFORNIA  92664 


